Summary of Role and Responsibilities
Field questions through inbound calls and emails while reviewing information across multiple systems.
Perform immediate after call work such as documenting in case and claim management systems and manually adding all applicable service fees.
Adhere to performance metrics to meet contractual service level agreements.
Work with internal and external clients to identify and resolve client, member, and provider issues while utilizing proper escalation channels.
Liaise with clients via phone, email or fax to obtain specific approval or authorization for precertification and to determine accurate and valid coverage information. Interpret and apply insurance benefits.
Learn about and assist with coordinating care and complex transportations to evacuate members needing a higher level of care including repatriations for medical necessity and mortal remains.
Participate in training, coaching, or individual feedback sessions with management and quality team.
All agents must maintain company quality standards pertaining to accuracy of information provided, adherence to scripting and tone/attentiveness.
This role requires agents to balance a large work-load with a high volume of inbound calls in order to provide assistance to callers in high stress and time sensitive situations (including medical emergencies) and maintain clear communication with a variety of clients.
Education, Experience, and Knowledge / Skills / Abilities
Minimum Education Requirements :
Associate’s degree (A. A.) or equivalent from two-year College or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
Knowledge, Skills, and Abilities
Basic knowledge of geography as well as a respect for a diversity of cultures, languages, and people.
Strong stress management skills and ability to multitask in a fast-paced environment.
Professional-level written and oral communication skills.
Preferred Education, Knowledge, Skills and Abilities :
Bachelor’s Degree in international studies, foreign language, business or related field preferred.
Conversational second language preferred.
Medical terminology or insurance certification.