Customer Service Representative @ HealthAxis Group

Customer Experience & Support (2)
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Customer Experience & Support (2)

COMPANY OVERVIEW:

HealthAxis is a prominent provider of core administrative processing system (CAPS) technology, business process as a service (BPaaS), and business process outsourcing (BPO) capabilities to healthcare payers, risk-bearing providers, and third-party administrators. We are transforming the way healthcare is administered by providing innovative technology and services that uniquely solve critical healthcare payer challenges negatively impacting member and provider experiences.

We live and work with purpose, care about others, act with integrity, communicate with transparency, and don’t take ourselves too seriously.

We're not just about business – we're about people. Our commitment to a people-first approach shapes everything we do, from collaborating as a team to serving our valued clients. We believe that creating a vibrant and human-centric environment can inspire engagement, empower our team members, and ignite a sense of purpose in all that we accomplish.

PURPOSE AND SCOPE:

***MUST HAVE A MINIMUM OF 2-YEARS CALL CENTER EXPERIENCE***

The Call Center Representative role is to receive, investigate and respond to all member and provider calls to review questions regarding claims, benefits or general inquiries in a timely and accurate manner.

PRINCIPAL RESPONSIBILITIES AND DUTIES:

Answers all telephone calls within established department standards
Tracks all calls within the Health Axis and IKA databases ensuring that documentation is concise and factual
Participates in new employee orientation program and ongoing education programs as directed by Supervisors
Responsible for fully understanding the OTC benefits, medical management processes, demographic change processes, and process for changing Primary Care Physicians (PCP)
Answers benefit questions, detailed claims inquiries and general questions from members and providers
Maintains a positive and professional attitude
Shifts may vary from 8am – 10pm EST Monday-Friday and potentially weekend hours may be required
Attention to detail is required to maintain quality metrics within the call center
Maintains appropriate current source documents and reference documents
Performs quality work within deadlines with or without direct supervision
Interacts professionally with other employees, customers and suppliers
Works effectively as a team contributor on all assignments
Works independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations
As required, re-directs calls to appropriate department
Participates in any projects as assigned by supervisors

CUSTOMER SERVICE:

Responsible for driving the HealthAxis culture through values and customer service standards
Accountable for outstanding customer service to all external and internal contacts
Develops and maintains positive relationships through effective and timely communication
Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner

EDUCATION, EXPERIENCE AND REQUIRED SKILLS:

High school diploma or general education degree (GED) required
Minimum of two years call center experience required
Previous experience in a customer service environment and health insurance preferred
An equivalent combination of education, training, and experience
Ability to read and interpret documents and calculate figures and amounts
Excellent oral and written communication skills including good grammar, voice, diction
Effective listening skills
Ability to perform work in an unbiased and analytical manner
Proficient in MS Office with basic computer and keyboarding skills
Excellent customer service skills (friendly, courteous, and helpful)

Customer Service Representative

HealthAxis Group

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