Customer Service Representative, Health Plan

Company Name:
Gundersen Lutheran Health System
Customer Service Representative, Health Plan
Department: Customer Service-HP
Schedule: Full-time
Shift: Days
Salary: $17.03
Hours: Temporary thru 4/30
Job Details:
Temporary Position through April
The Customer Service Representative acts as a resource for member, provider, agent, and group inquiries, and assists with member education, member calls, presentations and group orientations. The Customer Service Representative assists with Health Plan member retention efforts, timely follow-up and problem resolution, and supports the Health Plan offices at the Support Services Building and the Health Resource Center. The Customer Service Representative must maintain knowledge of all policies and procedures, and CMS, DHS, federal and state regulations, and NCQA standards, for administration of all lines of business including commercial fully insured and self-funded groups, BadgerCare Plus and Senior Preferred.
Education/Learning Experience:
- Required: High school degree or equivalent.
- Desired: Technical or Bachelors degree in business or health care field.
Work Experience:
- Required: 3 - 5 years previous work experience with insurance claims or customer service in a health insurance setting.
- Desired: Managed care experience; community education/group presentations, experience with ICD-9, CPT and HCPCS codes.
- Required: Excellent oral and written communication skills; ability to effectively present member materials at orientation sessions; competency in word processing applications; ability to interpret and appropriately apply policy provisions; knowledge of federal and state regulations; knowledge of medical terminology and managed care. Effective conflict resolution skills. Ability to work effectively with a team, and exercise sound judgment in handling assigned tasks including maintenance of strict confidentiality.
Physical Requirements/Demands of the Position: Carrying and/or pushing/pulling objects weighing less than 20 pounds. Performs detailed tasks, and often subjected to interruptions and changing work priorities.
Current Gundersen Employees Click Here to Complete an Internal Application

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