Customer Service Rep.

Summary of Position

• Receive, answer and/or record telephone/correspondence/e-mail inquiries from subscribers, providers, and other
  consumers relating to areas of coverage, payment of claims, membership status, medical management intake calls, etc.,
  under the various EmblemHealth medical/surgical, dental, hospital and Medicare plans.
• Review inquiries, correspondence, and email receipts. Prepare email resolutions, letters (form or narrative letter) and/or
  claims payment process adjustments.
• Perform written and verbal duties of the position to meet company goals for production and accuracy.
• Perform related claims approving and clerical work as assigned.
• Perform other duties as assigned or required.
• Regular attendance is an essential function of the job.

Principal Accountabilities

• Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and
  providers on the telephone, in person, and email/correspondence.
• Ability to detect and relate problem service issues to management.
• Ability to speak well on the telephone and maintain a positive telephone personality.
• Must be able to compose clear concise letters.
• If designated, sort and screen correspondence receipts and resolve via coding of additional payment, including salvage
  and/or completion by letter.
• Typing and PC skills.
• Ability to adapt to change and address multiple issues simultaneously.
• Good organizational skills.
• Must be available for training.