Call Center Representative

At Chesterfield Companies, we're passionate about excellence, innovation, and providing outstanding solutions in Risk Management and Benefit Administration. We take pride in creating a collaborative, energetic workplace where our team members are encouraged to grow, take initiative, and make a meaningful impact.

If you're looking for a career that's both rewarding and inspiring—where your ideas are valued and your growth is supported—we'd love to connect with you

SUMMARY: This position is responsible for managing all incoming telephone calls and general correspondence received from members of our Client's health plan and the providers who render treatment to these members.

DUTIES AND RESPONSIBILITIES:

• Provides quality and professional customer service to members and providers, including use of proper telephone etiquette.
• Responds to all communications received in a timely and professional manner.
• Educates members and providers about healthcare benefits.
• Resolves claim issues or concerns that may arise, including the following:
• Initiates requests for stop payments, re-issues, and/or check forgery.
• Initiates recalculation requests after verifying that benefits were incorrectly paid.
• Initiates pricing requests with the network when necessary.
• Forwards additional information to Claims Examiners for claims reprocessing when necessary.
• Researches entire file to ensure that all issues are addressed.
• Ensures follow-up on all claims issues that need resolution.
• Brings issues to the Supervisor's attention.
• Assists new CSRs with taking calls by shadowing.
• Assists as a backup the Provider Maintenance Specialist by accurately maintaining the integrity of our provider records and updating as needed.
• Provides backup in other areas, based on business needs.
• Assists as a backup all dental fax backs to provider.
• Assists as a backup for all faxes received by Chesterfield Resources.
• Performs other related duties as assigned by management.

QUALIFICATIONS:

• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
• Previous experience in a call center or customer service role is preferred, but not required
• Certificates, licenses and registrations required: None
• Computer skills required: Microsoft Office Suite
• Other skills required:
• Demonstrate a positive and cooperative work attitude, encourage teamwork among fellow employees and customers.
• Must be able to communicate effectively with clients, claimants and professionals.
• Must be proficient in Windows operating systems, or equivalent, and have basic computer skills including data entry.
• Must be organized, have the ability to multi-task, work independently and problem solve.

Position Hours: Monday - Friday 8 a.m. to 5 p.m.

If you are a motivated individual with a passion for customer service and enjoy working in a dynamic team environment, apply now to join our call center team

Job Type: Full-time

Pay: $ $18.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending