Responsibilities:
- Answer high-volume inbound calls and make outbound calls as needed.
- Assist patients/members with inquiries related to:
- Benefits, eligibility, and coverage
- Claims status and billing questions
- Provider information and referrals
- Appointment scheduling and general support
- Accurately document all interactions in CRM or healthcare systems.
- Verify insurance and demographic information.
- Provide clear explanations of policies, procedures, and next steps.
- Escalate complex or sensitive issues to appropriate teams.
- Maintain confidentiality and comply with HIPAA and company policies.
- Meet or exceed call center performance metrics (quality, productivity, attendance).
- Collaborate with internal teams to resolve customer concerns quickly and efficiently.