Call Center Representative

Job Type Full-time Description

Essential Functions

Direct communications with members, providers, and health plans
 

Confirmation of benefits and eligibility information to members, providers, and health plans
 

Provide confirmation of participating providers in the network
 

Provide claim status to members, clients, and providers
 

Resolve problems by identifying the customer's complaint; selecting and explaining the best resolution for the issue; and escalating to upper management when necessary
 

Keep managers informed of any issues that may require their attention to avoid or resolve an existing problem
 

Apply knowledge, experience, common sense, and critical thinking to all issues being dealt with. Multi-task and prioritize
 

Respond to general inquiries from members and providers (plan benefits, limits, co-pays, deductibles, policy procedures, reimbursements, etc.). Redirect callers when necessary
 

Follow up until completion on all issues that are not resolved on the initial contact, and keep parties updated on steps and actions taken
 

Service the maximum number of callers in the quickest and most efficient way without sacrificing the quality of the service 

Requirements

Job Specifications

Typically has the following skills or abilities:
 

1+ year of Member Services experience in the Healthcare industry
 

Proficient With Computers

English and Spanish bilingual
 

Preferred Skills

Strong understanding of health plan terminology

Experience With Nextgen

 VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here. 

Salary Description $15 - $17