Individual Service Representative

About the position

The Individual Service Representative at PacificSource plays a crucial role in providing high-quality customer service to individual applicants, members, producers, and internal customers. This position is responsible for processing enrollments, changes, and terminations in the Individual line of business, ensuring compliance with applicable policies and regulations, and maintaining accurate records. The representative will handle inbound and outbound calls, process time-sensitive documents, and support various customer inquiries, all while adhering to privacy policies and performance standards.

Responsibilities

• Process individual enrollments, changes, and terminations for subscribers and dependents via various formats.
• Answer incoming calls and document each call in the system.
• Audit and review new policies and pertinent documents using internal systems.
• Process discretionary billing items, refunds, cash transfers, and write-offs as needed.
• Monitor email queue and provide support to agents, members, and internal customers.
• Generate correspondence following company guidelines for consistency and accuracy.
• Maintain accuracy standards to meet department and company measures.
• Complete daily, weekly, bi-monthly, and monthly reports for active and terminated members.
• Electronically upload images into the imaging system and prepare documents for manual imaging if needed.
• Set up and maintain transactions including electronic payments and audit files of electronic funds transfer transactions.

Requirements

• Minimum of one year prior customer service, medical insurance, or healthcare-related experience required.
• High School diploma or equivalent required.
• Excellent communication skills, both verbal and written.
• Basic Excel knowledge and strong keyboarding skills.
• Problem-solving skills and ability to multi-task.
• Ability to articulate rates, contract provisions, and processes to customers.
• Ability to adhere to company and department policies and meet service expectations.

Nice-to-haves

• Insurance or healthcare experience preferred.

Benefits

• Equal opportunity employer with a commitment to diversity and inclusion.
• Supportive work environment fostering individual differences and talents.