Healthcare Customer Service Representative - Tallahassee, FL - Hybrid

About the Role In this Hybrid role based in Tallahassee, you will answer inbound calls, respond to basic customer questions, and provide consultancy on insurance and healthcare. You will help investigate and adjudicate claim characteristics, respond to provider appeals, advise provider review councils, and ensure service levels meet SLAs. What You'll Do

• Answer telephones and respond to basic customer questions and/or forwards to appropriate personnel, providing consultancy utilizing knowledge on insurance and healthcare.
• Develops and implements general insurance and health care policies in accordance with state and federal laws and provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions.
• Responds to provider appeals and meets with providers to resolve problems/issues.
• Advise provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs.
• Processes calls in a manner that ensures service level agreements (SLAs) are met or exceeded.
• Records calls, processes requests and updates account history with results of inquiry to include proper documentation.
• Interfaces with team members, management, and customers in reference to customer service issues.
• Review and recommends modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions. What We're Looking For
• 2+ years of customer service experience in any industry.
• Knowledge of basic help desk software, computer software and Microsoft Office applications.
• Strong problem-solving skills to bring inquiries to effective resolution.
• Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally.
• Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries. Compensation & Benefits
• Salary range: $37,440 - $41,600 per year (USD).
• All salaried, full-time candidates are eligible for generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.
• This is a remote position for candidates living in the state of Florida. To effectively work as a teleworker, employees should have a broadband Internet connection with minimum speeds of 24 Mbps download and 8 Mbps upload. Remote work details and development academies are available.