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Job TitleEmployer Service Rep
OccupationInteract with customers to provide basic or scripted information in response to routine inquiries about products and services. May handle and resolve general complaints. Excludes individuals whose duties are primarily installation, sales, repair, and technical support.
Job Order NumberWV0380826
Post Date04/17/2024
Job LocationWheeling,West Virginia 26003-2704
CountyOhio
Job Summary

Employer Service Rep is responsible for answering telephone calls from client contacts in a prompt and courteous manner, resolving any clients issues relating to claims and eligibility, and to respond to written inquiries from clients. The ESR is also responsible for keeping the Account Executive and management informed of any trends or issues identified. The ESR will be responsible for reviewing No Surprise Act (NSA) requests and responding in a timely manner. NSA responsibilities include, but are not limited to, negotiating on behalf of clients within given guidelines and keeping the client, Account Executive and direct management up to date on case progress and, preparing reporting for Executive Management to identify trends. Required: 1). High School Grad or equivalent. 2). Self starter and works independently. 3). Detail oriented with good problem solving skills. 4). Ability to prioritize and meet deadlines. 5). Maintains confidentiality. 6). Good communication skills. 7). Proficient in Microsoft office products (Word, Excel, Power Point). 8). Easily adapts to changes in work requirements. Desired: 1). Bachelor's degree from an accredited college or university. 2). Previous experience in enrollment, claims processing or call center. 3). Medical Terminology. 4). Knowledge of CPT and ICD-9/ICD-10 coding. 5). Knowledge of medical and hospital claims. 6. Knowledge of prescription coding (NDC). Responsibilities: 1). Answers all calls and correspondence in a timely, professional and friendly manner. 2). Resolves client issues. 3). Works with operations team to have claims processed or adjusted as needed. 4). Communicates with clients, members and providers as necessary to obtain information required to resolve issues. 5). Records and tracks all information clearly and accurately. 6). Activity report prepared and shared with management monthly. 7). Understands benefits and copay detail in order to relay this information clearly and accurately.

Salary $.00 / Competitive Salary
Pay On CommissionNo
Experience0None
Educational DegreeGeneral Equivalency Degree
License/Certification RequiredN/A
Tools RequiredNo
Foreign Language SkillsN/A
Testing RequiredN/A
Minimum TypingN/A
Minimum Data Entry SpeedN/A
Hours Per Week40
Duration151+Days
Requires Evening WorkNo
Requires Weekend WorkNo
SummerNo
ShiftDay
Is Public Transportation available to job site?No

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