The Portal Services Representative I will assist members, providers, and clients with web-based solutions, emphasizing education about portals, documentation of calls, and escalation of issues. Responsibilities include generating insights for internal departments and handling administrative tasks.
Important things YOU should know:
- Training & Production Schedule: Monday - Friday, 8:00am - 4:30pm CST
- Please know hours of operation are 8:00am – 6:00pm CST so shift could flex based on business need.
- Fully Remote
- Customer Service in Dental or Health Insurance experience a plus!
What will YOU be doing for us?
Increase member, provider and client use of our web based solutions for claims submission, payments, and authorizations.
What will YOU be working on?
- Provide education to callers on the benefits of utilizing the member and provider insurance portals.
- Service dental, medical, vision and physical therapy members and providers using the member and provider portals offered by SKYGEN USA.
- Provide feedback to multiple internal departments regarding issues found on the member and provider portals.
- Ensure all calls are answered according to company and client guidelines.
- Accurately document call information and resolution in internal systems while engaging with members and providers.
- Properly identify potential issues that are not easily resolved and escalate appropriately to Manager.
- Perform outbound calling projects as directed.
Additional Responsibilities:
- Utilize multiple modules in the Enterprise System to research portal questions.
- Work with internal departments to produce, maintain, and deliver portal training references and materials.
- Work with call center to resolve outstanding follow ups generated from incoming calls.
- Using automated systems, maintain updated data on portals by verifying accuracy and handling any exceptions or issues.
- Act as a liaison between portal users and clients to resolve escalated issues.
- Provide recommendations on system enhancements and process improvements to management.
- Assist department with administrative tasks and additional duties as needed.
What qualifications do YOU need to have to be GOOD candidate?
- Required Level of Education, Licenses, and/or Certificates
- High school diploma/GED required
- Required Level of Experience
- 1 year of customer service experience (Call Center, Provider Relations).
- Required Knowledge, Skills, and Abilities
- Intermediate knowledge of Microsoft programs (Word, Excel, and email)
- Excellent attention to detail
- Excellent oral and written communication skills
- Ability to successfully meet timelines for project plans
- Strong navigation skills and the ability to multi-task
What qualifications do YOU need to have to be a GREAT candidate?
- Preferred Level of Education, License, and/or Certificates
- Associates degree/2 year degree in related field
- Preferred Level of Experience
- 1-3 years of customer service experience (Call Center, Provider Relations).
- Preferred Knowledge, Skills, and Abilities
- Knowledge of contract terminology
- Understanding of reimbursement methods
- Knowledge of dental, medical, physical therapy and vision products and terminology
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