Customer Service Representative (Saipan)

Customer Service Department in Life & Health Division

 

As of October 25, 2023

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Responsibilities 

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• Answer calls and greet customers for the purpose of visit and directs them appropriately

• Verify inquiries for eligibility for medical, dental and vision services

• Receive and process group enrollment and change of status forms

• Address enrollment, cancellation and qualifying events issues

• Assist customers with deductible/reimbursement claim form

• Assist customers with medical inquiries and explanation of benefits and claim determinations

• Prepare letters for Customers / Groups on appointment information, denial letters and pending
  documents

• Assist Brokers on New Accounts and coordinate Renewals and other request

• Contributes to team effort

• Coordinate courier dispatch

• Enter customer and provider inquiries in a call tracking system

• Explain coverage according to schedule of benefits

• File group correspondence folder and enrollment forms in the account folder

• Maintain account listing as provided by Account Executive

• Maintain safe and clean reception area by complying with procedures, rules and regulations

• Notify company personnel of visitor arrival or caller and manages workflow activity

• Organize provider checks and manage provider check pick-up

• Prepare claim analysis report for customers

• Process HIPPA certificates

• Receive mail, documents, packages, courier deliveries and distribute items to appropriate
  personnel

• Report daily activity to the Manager / Supervisor

• Request and issue member cards

• Schedule and Coordinate off-island Appointments / Referrals

• Transmit customer receipts to claims department for processing

• Any other job related duties as assigned by Supervisor

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Requirements

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• High school diploma or equivalent required

• Must have excellent communication skills in verbal and written form

• Experience with Microsoft Office (ex: Outlook Express, Microsoft Word/Excel)

• Experience with operating Xerox machine (ex: Copy, Fax and Scan)

• Able to handle multiple assignments under high pressure

• Highly organized and dedicated with a positive attitude

• Thrive on working in a challenging environment

•  Team Player

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