Avesis
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
- As a Customer Service Representative your duties revolve entirely around providing empathy and compassion to Avesis’ Members, Customers, and Provider relationships.
- Responsibilities include, but are not limited to, developing and enhancing relationships, responding to inquiries, and investigating, analyzing, and resolving issues for our members.
- You will assist with eligibility verification, pre-authorizations, denials, along with claim status and payment amounts regarding their Dental, Vision, and ancillary benefits.
- This work will all be done using our internal Avesis resources and online portals.
- CSRs will be responsible for providing world-class customer service and maintain complete and accurate documentation of all interactions.
- Our chosen candidates will demonstrate responsiveness and a sense of urgency while resolving customer concerns and inquiries and maintain a high level of productivity and service quality standards while continually supporting individual, team, and company goals and initiatives.
Essential Job Functions:
- Answer 40-60 inbound calls, responding to inquiries ranging from routine to moderate complexity.
- Capture member information accurately and update systems with complete and concise data.
- Ensure flexibility, stay organized, and comply with constantly changing programs and business rules.
- Investigate issues that cannot be resolved at the time of initial call. Collaborate with internal teams to research and follow up with the Member until a resolution occurs.
- Comfortable working in the healthcare field, with an acute awareness for privacy, confidentiality and professionalism.
- Ability to determine proper issue escalation – joining forces with other internal departments for answers, therefore closing the loop and providing a solution for the Member.
Requirements:
- High School Diploma or GED required.
- 1 year of customer service experience required. Experience working in a high volume, healthcare, call center environment highly desired.
- Exposure to Medicare, Medicare Advantage, or Medicaid insurance claims preferred.
- Ability to work 40 hours/week, Monday – Friday, with availability between 7:00 a.m. and 8:00 p.m. Eastern Time required.
- Proficient computer skills including Microsoft Word, Excel, Outlook required.
- Capacity to work unencumbered and independently in a home office/virtual environment.
- Internet connection must be through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload required.
- Proficiency to navigate multiple computer software/systems and multi-screen functionality with ease.
- Demonstrated sensitivity, empathy, and compassion with Member callers.
- Able to maintain confidentiality and adhere to HIPPAA requirements.
- Excellent written communication: ability to document caller interactions in a concise manner.
- Active listening skills while providing exceptional customer service.
- Excellent verbal communication skills with the ability to present information in an empathetic, clear, way. Must be adaptable, flexible, and readily able to adjust to changing situations.
- Able to apply logical thinking when evaluating problems.
- Adept to interacting with diverse populations.
- Overtime may be required at times during peak seasons.
We Offer
- Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
- Competitive compensation package.
- Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
- Life and disability insurance.
- A great 401(k) with company match.
- Tuition assistance, paid parental leave and backup family care.
- Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
- Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
- Employee Resource Groups that advocate for inclusion and diversity in all that we do.
- Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.