Job Description
Customer Service Agent
Chicago, Illinois, United States
Full time
Description
Would you like to be part of a growing national healthcare solutions company? Are you looking to positively affect thousands of lives each day via health benefits?Are you looking to continue to grow your customer service career?
We are hiring for a Virtual Customer Service Agent to join our team.
Who we are
Allied is a national healthcare solutions company that supports healthy workplace cultures.
What we do
We are problem-solvers, innovators, and collaborators. Our purpose is to work with employers to take care of their employees and their families every day and it all starts with the Allied family.
What’s in it for you?
Allied supports an inclusive culture focused on developing employees to succeed, innovate & impact the community.
Here’s how we do it
Training and Development: Allied offers tailored learning and development curriculums for all employees and a Learning Management Database with thousands of courses for professional and personal development.
Career Mobility: Growth opportunities are endless at Allied. In 2021 alone, one in five employees had a job change. 75% of these job changes were promotions!
Employee Engagement:We pride ourselves on employee engagement! With our recognition program, employees recognize their colleagues monthly or donate to charities with cash rewards. Allied has a dedicated committee planning monthly engagement activities to create endless opportunities to get to know your peers and destress in this new remote world.
Employee Feedback: We regularly survey our employees throughout the year to seek continuous feedback, ideas and suggestions on new initiatives.
Community Outreach: We have dedicated committees focused on fundraising efforts supporting our employees and their families, furthering education goals and providing funds for charitable organizations outside of Allied.
What will you be doing?
Interact with plan members and providers in a virtual setting using Virtual Contact Center to answer questions or provide information in response to inquiries about employee benefit plans or claim issues; and be able to handle and resolve issues and complaints resulting from the calls. Plan members may be either English or Spanish speaking.
ESSENTIAL FUNCTIONS
- Confer with members and providers by telephone to provide information about employee benefit plans and/or claim issues or to obtain details of inquiries. Confer with members and providers by telephone to provide information about employee benefit plans and/or claim issues or to obtain details of inquiries.
- Keep records of member and provider interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.
- Resolve member or provider inquiries by verification of employee benefits or review of claim adjudication.
- Check to ensure that appropriate changes were made to resolve members’ or providers’ inquiries.
- Contact members or providers to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
- Refer unresolved members’ or providers’ inquiries to designated departments for further investigation.
- Check repositories (Alchemy, I status DB, Appeals DB and Med Review DB) for receipt of claims and other faxed or mailed information, (OI, Med Review, Student Status, other documentation sent to member) upon receipt of member or provider call.
- Complete adjustment request forms, accident detail forms, other insurance (OI) forms and temporary change of address records.
- Obtain and examine all relevant information to assess validity of complaints and to determine possible causes such as participant’s eligibility, timely filing of claim or member’s benefit plan design.
- Review employee benefit plan to determine whether a particular benefit is covered by the plan.
- Review claim(s) adjustment(s) to verify accuracy of original adjustment request.
- Meet and sustain productivity and quality metrics determined by management.
- Be able to take a minimum of 50 to 100 calls per day depending on queue assignment.
- Other duties as assigned.
EDUCATION:
College degree preferred, but not required.
EXPERIENCE:
2-5 plus years in call center environment with third party administrator, health insurance, or employee benefits company.
Spanish speaking a plus.
SKILLS & ABILITIES:
Ability to comprehend and utilize call center software applications in a virtual computerized environment.
Intermediate level work experience with Microsoft Office (Word, Excel, and Outlook software applications)
Able to demonstrate outstanding customer service skills through awards, recognition, or employer performance reviews.
WORK ENVIRONMENT:
This position is 100% remote.
Work station must have high-speed internet connection (minimum 25MB).
Work Schedule:
Rotating shifts between 7:30 AM to 7:00 PM M-Th, 8:00AM to 5:00 PM F and 9 – Noon Saturdays
Hiring is contingent upon successful completion of our background and drug screening process. Allied is a drug-free and tobacco-free workplace.
Diversity creates a healthier atmosphere: Allied is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.