Member Provider Services Rep I - call center customer service

What does PHCS offer you? Opportunity. Recognition. Satisfaction You've worked hard to get where you are, but you're ready for bigger opportunities that expand your skills and enrich your career. At Private Healthcare Systems, you'll have them. As the national leader in health care cost management with a growing national customer base, we have been building a strong and stable organization for over 21 years. We work together to exceed customer expectations and take everything we do to the highest standards of which we are capable. That means always learning, always seeking challenge, always respecting one another, and always putting forth our best effort. We are proud of what we are building at PHCS, and proud of what we offer. If you join our team, you will be too. PURPOSE OF POSITION: To provide quality customer service while effectively accepting and responding to customer calls and inquiries regarding network providers. To meet or exceed client expectations regarding quality and service levels expectations. Effectively accept and respond to customer's calls and inquiries regarding network related questions such as requests to add providers/hospitals to the network, fee schedule research, and contract clarifications. Document information from callers such as physician fee complaints, request for claim payment review in Contact Management System. Identify issues that need further review by Research Team and assign cases Essential Functions: Consistently meet or exceed standards for quality, customer service and call volume per department guidelines. Effectively communicate accurate provider information to customer Resolves and inputs provider requests into database within established P&P timeframes. Inputs provider issues or complaints into database for handling by appropriate staff. Confirm and correctly enter appropriate Provider demographic information into Facets. Provides customer satisfaction to both internal and external customers and strives to continuously improve service delivery by meeting and exceeding the Customer Service Operating Principles and Performance Standards.
REQUIREMENTS
Qualification: Require: High School Diploma 1+ years' customer service experience. Familiarity with telephone techniques and skills Ability to utilize PC keyboard efficiently and accurately. Proficient data entry skills. Working knowledge of personal computers and ability to navigate through software applications. Demonstrated verbal communication skills and ability to convey information clearly and effectively Ability to effectively handle multiple tasks in a fast paced environment Ability to identify problem issues and determine the appropriate course of action/redirection within department guidelines required to resolve issues Ability to resolve issues of conflict in a tactful and professional manner and to effectively diffuse irate callers Desired: Demonstrates an understanding of healthcare/managed care industry, types of services and general business processes Demonstrated problem solving skills Medical and Claim Terminology Telephone experience in similar call center environment and/or industry PHCS offers a competitive salary and excellent benefits which include major medical, dental, 401(k), tuition reimbursement and a generous paid time off plan. PHCS is an Equal Opportunity Employer. M/F/D/V