USA
19.00-20.00 per hour
Hourly
Full Time

Remote

Imagine360 is currently seeking a Customer Service Rep II to join our HealthFirst Team! In this position you will be receiving inbound calls from members, to help with inquiries involving benefit plans. You will act as an advocate for members by providing knowledge, expertise, and support to members and providers, guiding them throughout their healthcare experience. By educating members on resources and benefits available to them, the Customer Service Rep II plays a key role in the member's journey navigating the complexities and cost of healthcare.

Position Location: 100% Remote

Responsibilities include but are not limited to:

Deliver above and beyond service over multiple channels including phone, email, portal inquiries, etc. by acting as a single point of contact, maintaining ownership of member resolution
Become an expert in benefit administration, Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), Level Funded plans, minimal essential coverage plans and alternative benefit payment designs specifically reference based pricing
Guide understanding of health benefit coverage including accumulators, explanation of benefits, out of pocket maximums, reimbursement levels, and federal regulations such as NSA and ACA.
Take ownership of the member experience from beginning to end, reducing handoffs to others to ensure consistency and resolution
Anticipate the needs of members and conduct research on members' behalf to resolve issues
Educate members on pre and post services in conjunction with benefit to optimize the member experience throughout their healthcare journey
Collaborate with internal and external partners to ensure a best-in-class service delivery
Resolve member complaints
Treat all calls and correspondence using procedures and paying attention to the sections relating to HIPAA guidelines and the HIPAA Privacy Rules
Complete provider research, appointment scheduling, medical record retrieval and all other non-clinical duties assigned within applicable timeframes in compliance with Policy & Procedures
Accurate documentation in appropriate software

Required Experience / Education:

High school diploma or GED
1+ year healthcare industry work experience. Experience in delivering client-focused solutions based on customer needs within direct member contact and education. Ideally virtual/telephonic, in-person experience with the public.

Preferred Experience:

1+ year with telephonic verification of medical benefits. 2+ years healthcare experience i.e. carrier, TPA, patient advocate, or other benefits focused role. Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms).

Skills and Abilities:

Proficient in Microsoft Outlook, Word and Excel
Service-driven mindset
Aptitude for learning and retention
Advanced soft skills with a high level of emotional intelligence
Strong written communication skills

What can Imagine360 offer you?

Multiple Health Plan Options
Company paid employee premiums for disability, and Life Insurance
Parental Leave Policy
20 days PTO to start / 10 Paid Holidays
Tuition reimbursement
401k Company contribution
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company's diversity and inclusion initiatives

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Customer Service Rep II