Customer Service Representative

WHO WE ARE

NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.

NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.

he Membership Enrollment - Customer Service Representative I provides support to providers and members by answering calls regarding eligibility, benefits, claims, and service authorizations.

DUTIES & RESPONSIBILITIES

- The Membership Enrollment - Customer Service Representative job description is intended to point out major responsibilities within the role, but it is not limited to these items.

- Answering incoming calls from providers and members

- Provides eligibility, claims and authorization status.

- Retrieves voice mails and responds.

- Collaborates with internal and external partners to resolve issues from providers or members as they relate to claims payment, authorization and eligibility inquiries.

- Creates, tracks and completes Customer Service Incidents to internal departments to resolve caller issues.

- Participate in the discovery and resolution of root cause for recurring issues.

- Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.

- Use customer service best practices to ensure a positive customer experience.

- Meets daily, weekly, monthly metrics as written.

- Other duties and responsibilities as assigned.

EDUCATION AND PROFESSIONAL EXPERIENCE

- High School diploma or GED required.

- One (1) to three (3) years in the Health Insurance Industry preferred.

- One (1) to three (3) years of customer service experience required.

- Claims payor experience preferred but not required.

PROFESSIONAL COMPETENCIES

- Strong communication skills, both verbal and written

- Organized and able to prioritize work to meet deadlines

- Able to work independently with little supervision

- Able to thrive in an often-chaotic environment

- Able to understand regulatory and compliance rules

- Results and detail oriented

- To be positive and accountable

- Team unity

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.

For individuals assigned to a location(s) in California, NeueHealth is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant’s education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $17.42-$26.14 Hourly.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; Paid Time Off, and paid holidays.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of NeueHealth, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.