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Customer Service/Call Center Rep - Adjudication in Grand Rapids, MI at The Amynta Group

Date Posted: 11/28/2018

Job Snapshot

Job Description

POSITION SUMMARY:  Provides routine or standard customer service to internal or external customers.  Responsibilities may include providing standard information, completing forms within guidelines, and determining the status of claims based on plan guidelines.  

ESSENTIAL JOB FUNCTIONS:

May serve as a lead to new-hires or other staff, which includes providing work direction and providing second level support for customers.

Responds to standard questions and concerns from customers and follows-up with common questions to document the nature and status of the claim.

Completes a variety of forms and documents that require limited to no judgment based on guidelines and customer responses, scripted documents, and operational procedures. 

Processes routine or standard claims based the documentation and categorization of claims, informs customer of results, and closes out the claim as appropriate. 

Provides assistance to internal and external customers during the claim and general call center process; forwards calls to other team members, departments or supervisors as required.  

Utilizes databases, informs customers of claim status or outcome, and responds to questions and concerns.   

Performs basic office duties, such as copying, filing, faxing, typing standard documents, preparing, sorting, and distributing mail, entering data, and running basic or standard reports.

Performs other duties as assigned.

Job Requirements

EXPERIENCE REQUIREMENTS:

Office or customer service experience is preferred.

EDUCATIONAL REQUIREMENTS:

High school graduate or equivalent education and experience.   Post-secondary education is preferred.

SKILL REQUIREMENTS:

  1. Applying basic office principles;

  2. Providing basic customer service;

  3. Following instructions and guidelines;

  4. Entering data;

  5. PC skills; Microsoft Office applications (Word, Excel, PowerPoint, Outlook); and other applicable applications;

  6. Communicating with co-workers to provide and receive direction.

WORK ENVIRONMENT:

Professional office environment.

PHYSICAL REQUIREMENTS:

Positions in this class typically require: typing, talking, hearing, seeing and repetitive motions.

Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.  Sedentary work involves sitting most of the time.  Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

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