Customer Service Representative IV

City/State

Virginia Beach, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health is currently recruiting for a Full-Time,

Customer Service Rep IV in Norfolk, VA and surrounding areas.

This position is hybrid remote.

Responsible for all areas of customer service as it pertains to the acquisition and/or retention of members. Performs routine & complex servicing of operational issues for providers, members, benefit administrators (BAs) & brokers. Serves as the subject matter expert in customer operations for benefit administration, claims, pharmacy issues, group set up, enrollment, billing and broker commission issues.

CSR IV must have strong written and oral communication skills. In addition, at least 2 years or more years utilizing Microsoft Office. Proficient in Excel, Word and PowerPoint.

Job Requirements

• High School Grad or Equivalent
• Customer Service 5 years required OR
• Health Plan Claims 5 years
• Pharmacy Technician 5 years
• Sales 5 years

Benefits: Sentara offers an attractive array of full-time benefits including Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more. Sentara recognizes our employees by offering:

• Comprehensive health care plans
• Generous paid annual leave
• 401a/401k/403b plan
• Long and short-term disability
• Tuition Reimbursement
• Flex spending and life insurance
• You can expect employee recognition, performance rewards, plus countless services and programs to enhance work/life balance.

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans, and plans serving Medicare and Medicaid enrollees.

With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity.   Join a team that has a mission to improve health every day, join the Sentara Team! 

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

keywords: data entry, customer service, medical terminology, health plan

Job Summary

Responsible for all areas of customer service as it pertains to the acquisition and/or retention of members Performs routine & complex servicing of operational issues for providers, members, benefit administrators (BAs) & brokers. Serves as the subject matter expert in customer operations for benefit administration, claims, pharmacy issues, group set up, enrollment, billing and broker commission issues. Responsible for root cause analysis and trending of repeat service issues as they pertain to Optima Health's strategic initiatives with particular focus on easy to do business with (ETDBW) initiatives. Works with leadership to implement processes that support ETDBW initiatives.

5 years experience in customer service or Health Plan Claims or Marketing or Pharmacy Tech or Sales is required.

Qualifications:

HS - High School Grad or Equivalent (Required)

Customer Service, Health Plan Claims Disbursmnts, Marketing, Pharmacy Technician, Sales

Skills

Microsoft Access, Microsoft Excel, Microsoft Word

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission “to improve health every day,” this is a tobacco-free environment.