Employer: Trustmark Health Benefits
In this position, you will be 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.
Please note that this position will be fully remote and open to those living within the U.S.
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 flexible 37.5 hr. work week that includes holidays, rotating Saturdays and possibly Sundays.
- Applicants must have the flexibility to start as early as 6:00 am CST and be able to work as late as 8:00 pm CST. You will be provided with a set work schedule based on business needs.
- 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, generous 401(k) plan, wellness program, back-up care for children, adults and elders, paid holidays and paid time off.