Customer Service Representative – Remote Jobs – Lawrence, KS, USA – Prodigy


Provides a world-class customer service experience by trouble shooting and resolving complex customer inquiries from members, employers, and providers.

Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

Essential Functions

  • Research, resolve and respond to inquiries and correspondence via telephone, written communication and/or in person. Inquiries will be from members, providers, group leaders and internal staff regarding a diverse range of topics including, but not limited to, contract benefits, changes in coverage, eligibility, claims, provider networks, payments and appeals.
  • Uses critical thinking skills to determine course of action needed to resolve inquiry or complaint.
  • Must be comfortable being monitored for level of efficiency, accuracy and customer satisfaction and must be able to meet performance standards to achieve both individual and department goals.
  • Must be able to communicate effectively with appropriate tone and content. Customer Service calls are recorded to ensure accuracy and to provide a tool for feedback for reps.
  • Must be able to balance workload to ensure timely and accurate response to both internal and external customers.
  • Initiate claims adjustments and update enrollment information through the on-line systems as determined necessary through inquiries.
  • Must demonstrate the ability to listen, talk, type and perform research simultaneously using various research channels, both online and hard copy.
  • Must be able to follow a call guide.
  • Ability to provide education to our members and providers on various avenues available to them to obtain information such as the website.
  • Promote good working relations and positive work environment while acting as a role model to coworkers.
  • Must remain positive, pleasant, and helpful under a wide variety of circumstances including angry customers. Employee must be able to be on telephone constantly except for breaks and lunches and must wear a headset that plugs into the phone. Communication by telephone and direct personal contacts will consume 95% of the workday. Must operate a Personal Computer (PC) at least 95% of the day in which a sitting/stationary position is required. While performing the duties of this job, the employee is regularly required to talk or hear. Is subject to work standards and must achieve and maintain a commendable performance level in production and quality with minimal supervision. Must be able to adhere to a very strict schedule to include varying start and stop times and when allowed to go to break/lunch.

Qualifications

  • High school education or its equivalent required. College or continuing education courses in communications, interpersonal relationships, psychology, anatomy, physiology, medical terminology, composition or business letter writing is preferred.
  • Working knowledge of Blue Cross and Blue Shield of Kansas customer service systems is required upon completion of training.
  • Detailed knowledge of contracts, benefit coding, enrollment regulations, and legal issues such as HIPAA, COBRA, OBRA, and MSP are required upon completion of training.
  • Excellent customer service skills, problem solving skills and organizational skills are required.
  • Must be comfortable working individually in a structured environment.
  • Proficiency in Grammar, Spelling, Typing and Basic Math are required.
  • Two year’s experience navigating multiple computer systems preferred.
  • Two year’s customer service experience preferred.
  • Excellent human relations and communication skills are required with the ability to interact positively with external customers and all levels of internal staff

Customer Service Representative – Remote Jobs – Lawrence, KS, USA – Prodigy