Customer Service Representative (Remote)

Please note this role is fully remote.

The Phia Group provides, amongst other things, claim recovery services for health benefit plans. When a health benefit plan pays medical bills, and we later discover someone else should have paid those medical bills, The Phia Group – on behalf of the health plan – will seek to recover the funds. The ideal Customer Service Representative will present a service-driven mindset and strive for excellence in their interactions. Work in the Customer Service Department includes but is not limited to answering calls and written inquiries from clients, insureds, attorneys, and adjusters. The goal for a typical interaction is to collect accident details to determine potential sources of recovery and promote/demote those cases accordingly.

At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their dependents, you can look forward to not only exceptional benefits for yourself but also being immersed in a company that has been named one of USA Today’s top workplaces for 2024. We believe that this distinction, which stems from the fourth-annual survey co-sponsored by Energage and USA Today, reflects our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees.

As a Customer Service Representative, you will: support a positive caller experience by being available in our call queues, engaging with our customers, and educating our caller. In this role, you will perform a variety of day-to-day tasks to support recovery staff. Tasks may include managing a large amount of customer inquiries through calls, voicemails, faxes, scanned correspondence, and emails. You will utilize time management, written documentation, and decision-making skills that impact the day-to-day activities of the Recovery Department as well as additional tasks on an as-needed basis.

Essential Duties and Responsibilities

• Manage high-volume customer inquiries through phone calls, voicemails, faxes, scanned correspondence, and emails.
• Identify and assess customer needs to achieve maximum client satisfaction.
• Assist callers in real-time with data collection or education; Transfer/redirect calls to the appropriate Recovery Specialists when appropriate.
• Utilize internal systems and resources to provide accurate, valid and complete information relevant to the situation.
• Ensure adequate phone coverage with regular attendance and use of situational awareness during scheduled shift to minimize missed and abandoned calls.
• Review, promote, and activate both client & Phia generated referrals that result from Call Center activity.
• Collection and documentation of handling attorney and/or adjuster information to the appropriate tabs in the system along with any additional pertinent information, as-needed.
• Ensure all calls and/or case activations, data entry, and data management are handled within company guidelines.
• Maintain and respond to department requests submitted through the online questionnaire portal.
• Maintain and research automatic updates generated through a national database used to identify third party claims.
• Perform reviews of scanned documentation for systematic update such as Phia Accident Questionnaires
• Generate client specific reports on a weekly basis, as-needed.
• Responsible for protecting company assets from unauthorized access, disclosure and/or modification; as well as comply with the organization's information security policies.

Experience and Qualifications

• High School diploma or equivalent preferred
• Bilingual preferred, but not required
• Remote work or education experience
• Private workspace with closed off door for privacy
• Sufficient internet speed to support video, IP phone, and multi-system usage
• No distractions in home that would require assistance during working hours
• 2+ years of experience in one of the following ar