In this position, you are responsible for providing quality service by accurately and respectfully responding to telephone, written and electronic inquiries from employees/members, providers and clients. Inquiries include a variety of topics such as benefits, eligibility, claim status, claim disposition and so on. As a Customer Service Representative, you will have the ability to work from home and support our clients all time zones. We are currently hiring for a class of CSR’s who will start and participate in our next training class scheduled for 1/10/22.
Job Responsibilities include:
Respond to telephone, written and electronic inquiries from employees/members, providers, clients and other interested parties using system notes, plan documents and booklets, benefit reference documents, Claim Reference Manuals and claims-related memoranda.
Treat all inquiries professionally and respectfully following Health Benefits guidelines
Appropriately refer or escalate calls based on customer service procedures and guidelines.
Research inquiries and respond appropriately.
Appropriately refer unresolved inquiries or inquiries requiring further action to the appropriate individual, e.g. Analyst, Corrections, Senior, and Supervisor/Manager.
Follow-up regularly on outstanding issues to ensure timely resolution and client satisfaction.
Thoroughly and accurately document all inquiries using PowerSTEPP and Family Files following Health Benefits guidelines.
Communicate via telephone, email, electronic messaging, fax, or written letter with employees/members, providers of service, clients and/or other insurance carriers to ensure proper claim processing and issue resolution.
Initiate outgoing calls or other service projects as assigned.
Other duties as needed/assigned
Job Qualifications:
Previous customer service experience is required.
Ability to work in a fast-paced, customer service driven environment
Excellent verbal and written communication skills are required.
Ability to work effectively with team members, employees/members, providers, and clients
Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form.
Flexible; open to continued process improvement
Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word.
Prior experience in a fast-paced call center is strongly preferred.
Must be able to work a 37.5 hr. work week for the hours of 10 am – 6:00 pm CT.
Self-Funded Insurance/Benefits and/or TPA experience a plus.
Knowledge of medical procedure, diagnosis coding and medical terminology preferred.
Bilingual preferred.
Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools a plus.
Come join Trustmark! Join a team that will not only utilize your current skills, but will enhance them as well. Trustmark benefits include medical/dental/life insurance, very generous 401(k) plan, wellness initiatives and much more!
If you are a Colorado resident and this role is a field-based or remote role, you may be eligible to receive additional information about the compensation and benefits for this role, which we will provide upon request.
All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, sexual identity, age, veteran or disability.
Required Skills
Required Experience
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