Company Info

SKYGEN USA

W140 N8981 Lilly Rd
Menomonee Falls, WI, United States

Phone: 2629464982
Web Site:

Company Profile


Customer Care Representative


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Job ID:

5748

Location:

Menomonee Falls, WI, United States 

Category:

Customer Service

Salary:

13.50 and up per hour
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Job Views:

182

Zip Code:

53151

Employment Type:

Part time

Posted:

04.02.2019
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Job Description:

Are you looking for a full-time summer office job with flexibility to work part-time during the school year?  Then a Customer Care Representative at SKYGEN USA is the place for you!   Our shifts are Monday through Friday from 7am – 7pm…no weekends!   Plus, it’s a fun, comfortable work environment.  We are always looking for Rock STARs to join our team.
 
Job Purpose: Answer incoming member and provider calls in a timely and accurate manner to ensure questions and concerns are addressed. 
 
Essential Job Responsibilities:
  • Service members by communicating benefit information, providing information and resources necessary to understand benefit plan coverage, verify insurance coverage, and assist in locating providers.   
  • Service providers by communicating benefits, authorizations, claims, and eligibility information.
  • Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests.
  • Provide feedback to Provider Relations staff on high level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution.
  • Support enrollment activities including but not limited to updating eligibility, assigning primary care providers, and updating third party insurance information.
  • Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing of appeals and grievances.
  • Provide updates to providers with questions regarding the status of their credentialing application.
  • Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available.
  • Ensure all calls are answered according to company and client guidelines.
  • Accurately document call information and resolution in internal systems while engaging with customer.
  • Utilize effective diffusion techniques when necessary to ensure proper resolution is reached.
  • Properly identify potential issues that are not easily resolved and escalate appropriately to Team Leads or Manager.
  • Perform outbound calling projects as directed.
 
 

Job Requirements:

Minimum Qualifications:
Required Level of Education, Licenses, and/or Certificates
High school diploma or equivalent.
 
Preferred Level of Experience
1 year experience in a customer service environment;
 
Required Knowledge, Skills, and Abilities
Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and email.
Excellent communication skills
Strong customer service skills including active listening and ability to diffuse difficult situations.
Strong data entry/typing skills
Strong navigation skills and the ability to multi-task
Excellent attention to detail