Medical Insurance Client Service Representative

CLIENT SERVICE REPRESENTATIVE

Position Summary

The Client Service Representative is responsible for providing excellent client service to Allied members, including HR representatives, brokers, and other various clients. They are the main point of contact for all inquiries and issues and must provide resolution in a timely, professional, and courteous manner.

Essential Functions
• Act as the liaison between the client/broker and Allied Executives and Departments involved with the benefit plan.
• Promptly deliver client complaints to relevant departments, including, but not limited to, Claims, Eligibility, and Account Management.
• Serve as an additional resource for Account Managers as needed
• Provide communication to clients and brokers regarding claim issue resolution, reporting, industry-related and legislative information.
• Provide follow-up to month-end strategy by closing out open claim issues.
• Troubleshoot, identify, and improve internal processes with various Allied departments.
• Work with and foster relationships with other internal teams such as Claims and Eligibility.
• Help facilitate the renewal of existing cases by management of claim reviews and service level expectations.
• Work on special projects, duties, or tasks as assigned.

EDUCATION
• Bachelor’s degree or equivalent work experience.

Experience And Skills
• 1-3 years of Medical Claims experience is required.
• Claim processing experience a plus.
• Customer Service skills.
• Intermediate-level work experience with Microsoft Office, Word, Excel Access, and PowerPoint software applications. - Required
• RIMS Claim Processing System – Preferred
• Web-Based Applications – Required
• Excellent verbal and written communication skills.
• Excellent organizational skills and attention to detail.
• Ability to prioritize tasks and to delegate them when appropriate.
• Ability to function well in a high-paced and at times stressful environment.

POSITION COMPETENCIES
• Job Knowledge
• Time Management
• Accountability
• Communication
• Initiative
• Customer Focus

PHYSICAL DEMANDS
• This is an office environment requiring extended sitting and computer work.

WORK ENVIRONMENT
• Remote

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