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Company Name : Sapphire™
Location : Lyndhurst, NJ
Position : Call Center Representative
Job Description : At Sapphire, now a part of Zelis, we believe in a world where health care consumers empowered with the right information at the right moment will become the best healthcare consumers for themselves, their health plans, and their providers. Are you interested in making an impact and supporting health care consumers? Join Sapphire as a Call Center Representative! We are seeking candidates with call center and healthcare experience. This is a remote position!
Proof of Covid-19 vaccination is required upon hire.
In this position, you’ll be responsible for:
Answering inbound calls from Sapphire’s health plan, employer group clients, or Sapphire employees.
Providing exceptional and professional assistance in a timely, energetic, and polite manner, to members (consumers) planning to have an elective surgical or medical procedure.
Documenting and communicating information to consumers, including answering inbound calls, emails, or chats; and placing outbound follow up calls, emails, or chats and/or responding to consumers emails or voicemails in a timely manner.
Utilizing internal databases to run reports on consumer claim history, procedure code matching, accounts on hold, incentive check fulfillment status, claim load schedule, shopping confirmation codes, exception payments, and consumer shopping search history.
Corresponding with consumer’s health insurance carriers to obtain, validate, and confirm accurate claim status information, or consumer program eligibility status.
Calling members’ site of service as needed to confirm the status of insurance claims.
Using analytical thinking and problem-solving to recognize, document, and alert the management team of trends in member calls, complaints, reward incentives not paid, or other department level performance improvement opportunities.
Assisting the Leadership team in preparing monthly reports on the department’s performance.
Other duties as assigned for the purpose of expanding the individual’s knowledge, skills, abilities, and experiences in preparation for advancement and promotion within Sapphire.
You might be a good fit if you have:
1-2 years of customer service experiences i.e., quickly developing rapport and credibility with customers are required.
1-2 years of call center experience
1-2 years of healthcare experience
An Associate’s degree in a healthcare related field (highly desired but not required).
Familiarity with using healthcare claims look-up and management systems.
Familiarity with using and supporting online consumer shopping tools.
Familiarity with using customer relationship management systems (Salesforce).
Good consumer focus with a strong aptitude to work with different personalities, ethnicities and age groups.
Strong customer telephonic communication experience and active listening skills.
Demonstrable analytical thinking and independent problem-solving skills, including the ability to multitask, set priorities and manage time effectively.
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This post is listed Under New Jersey jobs
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