Health Care Customer Service Representative Job Description

Health Care Customer Service Representative Job Description

August 20th, 2019

Health Care Customer Service Representatives supply individuals with details about the extent of their health insurance coverage. Health Care Customer Service Representatives typically work in call centers owned by or affiliated with health insurance providers.

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Health Care Customer Service Representative Job Description Template

We are searching for a patient and attentive Health Care Customer Service Representative to join our bustling organization. You will be required to field scheme-related queries from customers, provide pre-authorizations for medical treatment, and outline information regarding co-payments. You should also advise current and prospective members about the most suitable plans based on their needs.

To ensure success as a Health Care Customer Service Representative, you should be able to process and disseminate vast amounts of information. An outstanding Health Care Customer Service Representative will possess an aptitude for learning and continual development.

Health Care Customer Service Representative Responsibilities:

  • Familiarizing yourself with and remaining up-to-date with changes in our plans and tariffs.
  • Greeting customers in a friendly, professional manner using the suggested script.
  • Answering telephonic and e-mail inquiries in a timely manner.
  • Deferring queries to your line manager if you are unable to answer them.
  • Furnishing members and health care practitioners with details regarding members' benefits.
  • Granting pre-authorizations for medical treatment, if covered.
  • Advising members of outstanding co-payments.
  • Providing extant and prospective members with the details of network providers.
  • Canceling members' plans upon their request, or due to recurrent non-payment, if directed by your line manager.
  • Ensuring that your workspace remains tidy, and that you are equipped with all relevant tools and resources.

Health Care Customer Service Representative Skills:

  • High school diploma or equivalent.
  • Prior experience as a Customer Service Specialist or equivalent, ideally within a similar setting.
  • Sales experience is highly advantageous.
  • Computer literate with an above-average typing speed.
  • Superb verbal and written communication skills.
  • Thorough, with excellent listening skills.
  • Ability to calm irate, anxious, or grieving customers.
  • Capacity to navigate stressful situations with ease.
  • Available to work shifts, which may include work during evenings, weekends, and public holidays.

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