Experienced Customer Service Representative – Work From Home Opportunity at careerzynith
At careerzynith, we're dedicated to revolutionizing the way healthcare is delivered, making it more personal, convenient, and affordable for everyone. As a Customer Service Representative at careerzynith, you'll play a vital role in bringing our heart to every moment of our customers' health. If you're passionate about delivering exceptional customer experiences and have a knack for problem-solving, we want to hear from you!
**About careerzynith**
careerzynith is a leading healthcare company that's committed to transforming the way healthcare is delivered. Our purpose is to bring our heart to every moment of our customers' health, and we're anchored in our brand with heart at its center. Our Heart At Work Behaviors support this purpose, empowering our employees to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions.
**Work From Home Opportunity**
As a Customer Service Representative at careerzynith, you'll have the flexibility to work from home, enjoying a better work-life balance and reduced commuting time. This role is perfect for those who value flexibility and are self-motivated. You'll be part of a dynamic team that's passionate about delivering exceptional customer experiences.
**Responsibilities**
As a Customer Service Representative at careerzynith, you'll be responsible for:
* Maintaining a positive, empathetic, and professional attitude toward customers at all times
* Responding promptly to customer inquiries and resolving customer complaints
* Communicating with customers through various channels, including phone, email, and chat
* Processing orders, forms, applications, and requests
* Keeping records of customer interactions, transactions, comments, and complaints
* Communicating and coordinating with colleagues as necessary
* Providing feedback on the efficiency of the customer service process
* Managing a team of junior customer service representatives (in the future)
**Position Summary**
As a Customer Service Representative at careerzynith, you'll be responsible for answering questions and resolving issues based on phone calls/letters from members, providers, and plan sponsors. You'll triage resulting rework to appropriate staff and provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team. You'll also be responsible for extensive claims research on multiple platforms to assist providers with payment questions.
**Key Responsibilities**
* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors
* Triages resulting rework to appropriate staff
* Provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team
* Extensive claims research on multiple platforms to assist providers with payment questions
* Provides the customer with related information to answer the unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc.
* Uses customer service threshold framework to make financial decisions to resolve member issues
* Explains member's rights and responsibilities in accordance with contract
* Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system
* Educates & assists providers on our self-service options
* Assists providers with credentialing and re-credentialing and contracting questions and issues
* Assists in compiling claim data for customer audits
* Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals
**Required Qualifications**
* MUST live in the state of Oklahoma full-time
* Familiarity with Microsoft Office products
* Experience in highly transactional call center environment
* Excellent customer service and critical thinking
* High-speed internet access (25 mbps or higher) and consistent connection
* Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6-foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.
**Education**
* High School diploma or GED equivalent.
**Training and Onboarding**
* Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST.
* After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST.
**What We Offer**
* Competitive salary and benefits package
* Opportunities for career growth and professional development
* Flexible work arrangements, including work from home options
* Collaborative and dynamic work environment
* Recognition and rewards for outstanding performance
* Access to cutting-edge technology and tools
* Opportunities to make a meaningful impact in the healthcare industry
**How to Apply**
If you're passionate about delivering exceptional customer experiences and have a knack for problem-solving, we want to hear from you! Apply now to join our team as a Customer Service Representative at careerzynith.
Apply for this job
**About careerzynith**
careerzynith is a leading healthcare company that's committed to transforming the way healthcare is delivered. Our purpose is to bring our heart to every moment of our customers' health, and we're anchored in our brand with heart at its center. Our Heart At Work Behaviors support this purpose, empowering our employees to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions.
**Work From Home Opportunity**
As a Customer Service Representative at careerzynith, you'll have the flexibility to work from home, enjoying a better work-life balance and reduced commuting time. This role is perfect for those who value flexibility and are self-motivated. You'll be part of a dynamic team that's passionate about delivering exceptional customer experiences.
**Responsibilities**
As a Customer Service Representative at careerzynith, you'll be responsible for:
* Maintaining a positive, empathetic, and professional attitude toward customers at all times
* Responding promptly to customer inquiries and resolving customer complaints
* Communicating with customers through various channels, including phone, email, and chat
* Processing orders, forms, applications, and requests
* Keeping records of customer interactions, transactions, comments, and complaints
* Communicating and coordinating with colleagues as necessary
* Providing feedback on the efficiency of the customer service process
* Managing a team of junior customer service representatives (in the future)
**Position Summary**
As a Customer Service Representative at careerzynith, you'll be responsible for answering questions and resolving issues based on phone calls/letters from members, providers, and plan sponsors. You'll triage resulting rework to appropriate staff and provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team. You'll also be responsible for extensive claims research on multiple platforms to assist providers with payment questions.
**Key Responsibilities**
* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors
* Triages resulting rework to appropriate staff
* Provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team
* Extensive claims research on multiple platforms to assist providers with payment questions
* Provides the customer with related information to answer the unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc.
* Uses customer service threshold framework to make financial decisions to resolve member issues
* Explains member's rights and responsibilities in accordance with contract
* Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system
* Educates & assists providers on our self-service options
* Assists providers with credentialing and re-credentialing and contracting questions and issues
* Assists in compiling claim data for customer audits
* Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals
**Required Qualifications**
* MUST live in the state of Oklahoma full-time
* Familiarity with Microsoft Office products
* Experience in highly transactional call center environment
* Excellent customer service and critical thinking
* High-speed internet access (25 mbps or higher) and consistent connection
* Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6-foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.
**Education**
* High School diploma or GED equivalent.
**Training and Onboarding**
* Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST.
* After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST.
**What We Offer**
* Competitive salary and benefits package
* Opportunities for career growth and professional development
* Flexible work arrangements, including work from home options
* Collaborative and dynamic work environment
* Recognition and rewards for outstanding performance
* Access to cutting-edge technology and tools
* Opportunities to make a meaningful impact in the healthcare industry
**How to Apply**
If you're passionate about delivering exceptional customer experiences and have a knack for problem-solving, we want to hear from you! Apply now to join our team as a Customer Service Representative at careerzynith.
Apply for this job