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Customer Service Rep - PEHP
Job Field: Government Jobs
Location: SALT LAKE CITY, UT
Salary: $12.81 - $16.01 Hourly
Job Type: Full Time
Location: SALT LAKE CITY, UT
Salary: $12.81 - $16.01 Hourly
Job Type: Full Time
JOB SUMMARY:
Performs a variety of duties to handle incoming calls regarding claims status, eligibility and verification of benefits, for all PEHP plans. Education and Experience Graduation from high school; AND one (1) year of progressively responsible experience performing a variety of duties including to handle incoming calls regarding claims status, eligibility and verification of benefits plans; OR an equivalent combination of education and experience. Specific experience in claims customer service or claims adjudication, and various administrative functions is preferred. Knowledge, Skills, and Abilities Requires considerable knowledge of claims adjudication policies, procedures and processes; intricacies related to medical, dental, pharmacy, mental health, home health, chiropractic claims, and Medicare Supplement claims; medical terminology; various office management systems related to alpha and numeric record keeping; interpersonal communication skills; public relations skills; telephone etiquette; personal computer operations (PC/MS DOS) and various program applications; basic bookkeeping; negotiation techniques; some knowledge of 10 key operation; basic mathematics. Must have the ability to analyze a variety of routine claims management issues and problems and make routine corrections; communicate effectively verbally and in writing; ability to follow written and verbal instructions; establish and maintain effective working relationships with professionals, executives (public and private) department heads, co workers and the public; work independently and deal effectively with stress caused by heavy workload and handling difficult or irate phone calls. Work Environment Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.
Performs a variety of duties to handle incoming calls regarding claims status, eligibility and verification of benefits, for all PEHP plans. Education and Experience Graduation from high school; AND one (1) year of progressively responsible experience performing a variety of duties including to handle incoming calls regarding claims status, eligibility and verification of benefits plans; OR an equivalent combination of education and experience. Specific experience in claims customer service or claims adjudication, and various administrative functions is preferred. Knowledge, Skills, and Abilities Requires considerable knowledge of claims adjudication policies, procedures and processes; intricacies related to medical, dental, pharmacy, mental health, home health, chiropractic claims, and Medicare Supplement claims; medical terminology; various office management systems related to alpha and numeric record keeping; interpersonal communication skills; public relations skills; telephone etiquette; personal computer operations (PC/MS DOS) and various program applications; basic bookkeeping; negotiation techniques; some knowledge of 10 key operation; basic mathematics. Must have the ability to analyze a variety of routine claims management issues and problems and make routine corrections; communicate effectively verbally and in writing; ability to follow written and verbal instructions; establish and maintain effective working relationships with professionals, executives (public and private) department heads, co workers and the public; work independently and deal effectively with stress caused by heavy workload and handling difficult or irate phone calls. Work Environment Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.
KEY REQUIREMENTS:
High School Diploma
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