Note: The job is a remote job and is open to candidates in USA. Montage Health is seeking a Customer Service Representative I to assist health plan members and healthcare providers with inquiries related to eligibility, claims status, and benefits. The role is essential for supporting members, requiring a compassionate and solution-oriented individual to handle various customer interactions efficiently.

Responsibilities

• Interacts with customers (client, member and provide) via telephone, email, or in person to provide support and information specific to eligibility, benefits, claims, prior authorization requirements and appeals
• Document all communication in the applicable system of record
• Provide proactive education to customers, as it relates to their specific inquiry
• Provide accurate and timely responses to all customer inquiries
• Successfully bring all issues to closure within appropriate timeframe
• Provide support and coverage to inter-departmental staff as needed
• Coordinate customer appeals and grievances with appropriate staff
• Perform other activities and functions as assigned

Skills

• Excellent verbal and written communication skills, including active listening
• Minimum three years' experience in customer service, call center, or similar
• Service-oriented; Ability to resolve customer complaints and issues while maintaining a professional and calm demeanor
• Ability to operate spreadsheet, word processing programs and computer equipment required to fulfill position responsibilities
• Exceptional diplomacy skills to effectively resolve issues under sometimes tense and stressful circumstances
• Excellent phone manner
• Ability to use sound judgement, identify next steps to be taken, and develop appropriate solutions
• Associates degree, or applicable professional experience, required
• Minimum 1 to 3 years experience in a customer service, hospitality, or call center
• Bilingual Spanish/English desired

Benefits

• Competitive benefit package

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