Job Description

Job Title: Customer Service Representative

Location : Indianapolis, IN

This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services. Also may be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.

Essential Functions and Responsibilities:

• Meets the Department standard of calls answered, and call documentation entered.
• Assists Members and Providers with questions and concerns.
  • Finding Provider(s)/Services for members
  • Arrange Transportation for members
  • Answer billing/claims status questions; resolve claim issues for members
  • Assist with pharmacy issues
  • Help Members access community support services
  • Verify member eligibility
  • Quote benefits
  • Assist with Referrals
  • Assist with member health assessments
  • Assist members with closing gaps in care
• Ongoing member education.
• Responsible for all benefits information given to Members and Providers.
• Participates in Departmental Projects, as appropriate.
• Coordinates quality improvement initiatives with Medical Management, Provider Relations, and Quality Depts., i.e., Preventative Health Screenings.
• Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.

Requirements

• Must be Burmese Speaking – Required
• High School Diploma, required
• 1+ year of Customer service related role with direct contact with customers via telephone, email, chat and/or face-to-face

Vital Tech Solutions is an Equal Opportunity Affirmative Action employer. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits promotions, training, termination or any other condition of employment or career development. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, veteran status, disability status or any other legally protected status.

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