COMPANY OVERVIEW:

HealthAxis is a prominent provider of core administrative processing system (CAPS) technology, business process as a service (BPaaS), and business process outsourcing (BPO) capabilities to healthcare payers, risk-bearing providers, and third-party administrators. We are transforming the way healthcare is administered by providing innovative technology and services that uniquely solve critical healthcare payer challenges negatively impacting member and provider experiences.

We live and work with purpose, care about others, act with integrity, communicate with transparency, and don’t take ourselves too seriously.

We’re not just about business – we’re about people. Our commitment to a people-first approach shapes everything we do, from collaborating as a team to serving our valued clients. We believe that creating a vibrant and human-centric environment can inspire engagement, empower our team members, and ignite a sense of purpose in all that we accomplish.

PURPOSE AND SCOPE:

***MUST HAVE A MINIMUM OF 2-YEARS CALL CENTER EXPERIENCE***

The Call Center Representative role is to receive, investigate and respond to all member and provider calls to review questions regarding claims, benefits or general inquiries in a timely and accurate manner.

PRINCIPAL RESPONSIBILITIES AND DUTIES:

• Answers all telephone calls within established department standards.
• Tracks all calls within the Health Axis and IKA databases ensuring that documentation is concise and factual
• Participates in new employee orientation program and ongoing education programs as directed by Supervisors
• Responsible for fully understanding the OTC benefits, medical management processes, demographic change processes, and process for changing Primary Care Physicians (PCP)
• Answers benefit questions, detailed claims inquiries and general questions from members and providers
• Maintains a positive and professional attitude
• Shifts may vary from 8am – 10pm EST Monday-Friday and potentially weekend hours may be required
• Attention to detail is required to maintain quality metrics within the call center
• Maintains appropriate current source documents and reference documents
• Performs quality work within deadlines with or without direct supervision
• Interacts professionally with other employees, customers and suppliers
• Works effectively as a team contributor on all assignments
• Works independently while understanding the necessity for communicating and coordinating work efforts with other employees and organizations
• As required, re-directs calls to appropriate department
• Participates in any projects as assigned by supervisors

CUSTOMER SERVICE:

• Responsible for driving the HealthOps culture through values and customer service standards
• Accountable for outstanding customer service to all external and internal contacts
• Develops and maintains positive relationships through effective and timely communication
• Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner

EDUCATION, EXPERIENCE AND REQUIRED SKILLS:

• High school diploma or general education degree (GED) required
• Minimum of two years call center experience required
• Previous experience in a customer service environment and health insurance preferred
• An equivalent combination of education, training, and experience
• Ability to read and interpret documents and calculate figures and amounts
• Excellent oral and written communication skills including good grammar, voice, diction
• Effective listening skills
• Ability to perform work in an unbiased and analytical manner
• Proficient in MS Office with basic computer and keyboarding skills
• Excellent customer service skills (friendly, courteous, and helpful)

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