Health Insurance Call Representatives - 100% Remote

S&S Health is a premier healthcare administration company located in Cincinnati, Ohio. We offer self, level, and fully funded solutions that lower costs while improving outcomes with a consumer-centric experience. Our integrated benefits, services, and technology platform have been developed to serve the needs of Employers, TPAs, and Health Systems. The company has a nationwide presence with the ability to sell and service in every state. 

We are looking for highly motivated and client-focused individuals to join our growing team as a Health Insurance Call Representatives.  Applicants must have prior call center experience working at a insurance company, broker or Third-Party Administrator. 

The Health Insurance Call Representative provides expert service to providers, members, and clients who have claims, eligibility, and benefit-related questions by promptly responding to their concerns in a timely manner. In addition, this position resolves payment/adjudication questions at the time the call is received; explaining calculation methodology, contract terms procedures, etc. for the designated call center within S&S Health. 

Shifts Available: 8:30am - 5pm, 9am - 5:30pm, 9:30am - 6pm shift(s) are available!

Essential Functions:  

· Help providers and members navigate the complex healthcare ecosystem  

· Field member and provider inquiries by phone and email  

· Customer service focus with a keen understanding of the importance of average speed of answer, average handle times, abandonment rates, and first call resolution  

· Clearly communicates claims status, payment methodology, contract terms, procedures, etc. to providers, members, and clients.
 

Minimum Qualifications:  

· Must have prior experience working in a healthcare insurance company or TPA/Broker insurance office. 

· 2+ years Healthcare Call Center experience is required 

· 1+ years of demonstrated knowledge of health claims, coding, and processing guidelines.   

· Knowledge of plan designs, PPO, indemnity plans, and any healthcare plan documents. 

· Strong interpersonal skills to interact with customers, management, and peers.   

· High level of self-motivation, productivity, and attention to detail; be well-organized; have excellent verbal and written communication skills  

· Flexibility to work evening hours based upon business need  

· Excellent attendance required