Job Description
Job Description
Department: Health Concierge Customer Service Representative
Reports to: Customer Service Supervisor
Job Purpose:
IBA Health Concierge Customer Service. You will be part of our Inbound Call Staff. The mission of this model is designed to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service allows maximization of inbound and outbound touchpoints to solve members’ needs by taking ownership to resolve issues that arise by advocating on behalf of our members. You will also service our Providers by helping them coordinate care; answer benefit, claim & eligibility questions on behalf of our Members.
Key Responsibilities:
- Taking inbound calls for both Members and Providers
- Assisting providers to answer questions related to members health plan.
- Schedule appointments for preventative health screenings, COVID-19 vaccinations, or other healthcare appointments.
- Making outbound calls on behalf of our members to help resolve any billing issues or questions regarding their benefits.
- Help our members understand their health insurance and how to use it, including helping them change primary care physicians, locating urgent care clinics, and getting precertification for specific services.
- Perform review of member claim history to ensure accurate tracking of benefit applied; including but not limited to maximums and/or coinsurance/deductible and uses applicable system tools and resources to resolve the member’s needs.
- Guide the member through their plan of benefits, International Benefit Administrators policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines.
- Taking accountability to fully understand the member’s needs by building a trusting and caring relationship with the member. Anticipates Customer needs. Provides the Customer with related information to answer the unasked questions with a First Call Resolution.
- Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools.
Qualifications:
· Ability to multi-task, prioritize and effectively adapt to a fast-paced changing environment required.
· Strong written & verbal communication skills required.
· Intermediate typing skills – 50 wpm.
· Previous experience in customer service or related field.
· Highly perceptive individual with strong self-awareness and empathy in interacting with various audiences.
· Demonstrated organizational and communication skills required.
· Ability to work effectively in a team environment required.
· Ability to learn and retain in a complex environment.
· Possess top-notch people skills – listening, caring, connecting, empathy, and supporting.
· Deep problem-solving skills with demonstrated ownership of issue resolution.
· Demonstrated ability to uphold IBA’s values of caring, inspiration, integrity, and excellence in each member interaction and in building team cohesiveness.
· Demonstrated propensity for responsiveness and a sense of urgency when helping members.
· Highly perceptive individual with strong self-awareness and empathy in interacting with various audiences.
· Ability to seamlessly, multi-task while using multiple systems, to efficiently provide service to members.
Working Conditions:
This position requires working in an office environment.
The CSR may be required to work evenings, weekends, or holidays based on business needs.
The role involves sitting for extended periods and using a computer and telephone extensively
Wi-Fi cannot be used. You will need an Ethernet cable connecting the modem to the computer to test the results for the internet speed.
Education:
High School Diploma or G.E.D required – College degree or equivalent work experience strongly preferred
Company DescriptionInternational Benefits Administrators (“IBA”) is a TPA, founded in 1972, that specializes in the design, implementation & administration of self funded health and dental plans. IBA also provides claims paying support for several medical insurance carriers.
Company Description
International Benefits Administrators (“IBA”) is a TPA, founded in 1972, that specializes in the design, implementation & administration of self funded health and dental plans. IBA also provides claims paying support for several medical insurance carriers.