PRINCIPAL DUTIES AND RESPONSIBILITIES

· To obtain and maintain a working knowledge of the multiple benefit schedules, as well as a clear understanding of the eligibility system, claim system, and the Reciprocity system (ERTS)

· Respond timely and accurately to phone calls, e-mail, walk in participants, and correspondence by answering questions; explaining claim payments and claim denials; quote self-payment amounts; verify eligibility and/or benefits; research eligibility or claim issues; update eligibility with outside vendors

· Document all phone calls in the Customer Service module

· Perform various clerical duties (i.e., enter enrollment forms; process working spouse forms, process special fund claims; process disability claims, etc.).

· Navigate and provide accurate information regarding FMCP website

· Monitor incoming calls and calls waiting via call management system

· Pick up and handle messages from nightline

· Work on special projects as requested by Management

· Other duties as assigned

REQUIRED AND PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES

· 1+ years of call center experience in a medical billing or medical insurance call center environment, or 1+ years of processing medical claims

· Proficient in Microsoft Outlook & Word

· Bachelor’s degree or equivalent experience required

· Previous TPA or major insurance carrier experience strongly preferred, but not required

· Excellent written & verbal communication skills

· Demonstrates ability to manage complex issues while maintaining a flexible, positive, and cooperative demeanor

· Responds in a timely manner to operations leaders and stakeholders to facilitate informed decision-making

· Troubleshoots assigned issues, gathers evidence, and investigates all relevant information with participants, vendors, and internal departments to resolve the problem in a cooperative and collaborative manner

· Dependability – ensures timely arrival and consistent attendance to support the achievement of the team’s goals.

Job Type: Full-time

Pay: From $20.00 per hour

Experience level:

• 1 year

Shift:

• Day shift
• Morning shift

Weekly day range:

• Monday to Friday

Work setting:

• Call center
• In-person
• Office

Ability to commute/relocate:

• Rossville, GA 30741: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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