<span>Customer Service Representative - St. Luke&#x27;s Health Plan</span>

Saint Luke's Health System - Boise, ID

Full-time - Entry Level

Boise, ID

Hospitals

About the position

The Customer Service Representative for St. Luke's Health Plan serves as the first point of contact for members, providing exceptional customer service and support. This role involves handling inquiries related to benefits, assisting members with understanding their healthcare coverage, and ensuring accurate and timely information is provided. The representative must demonstrate excellent communication skills and a thorough understanding of the health plan's products and services across various lines of business.

Responsibilities

• Serve as the primary point of contact for members contacting the call center.
• Handle inquiries and assist with benefit-related questions.
• Listen actively to members' needs and concerns, demonstrating empathy and understanding.
• Provide accurate and timely information and assistance to members.
• Handle various member interactions including phone calls, emails, portal inquiries, and social media inquiries.
• Utilize knowledge of insurance benefits across multiple lines of business to assist members.
• Explain coverage details clearly to help members make informed decisions.
• Assist members in understanding how their medical claims were processed.
• Explain complex billing statements and claims processing terminology clearly.
• Provide detailed information on deductible, copayment, coinsurance, and out-of-pocket expenses.
• Collaborate with the claims department to address discrepancies or concerns.
• Investigate and troubleshoot member issues, resolving problems within the scope of the role.
• Document all interactions and resolutions accurately in the appropriate systems.
• Educate members on their appeal rights and the appeals process.
• Participate in quality assurance initiatives to ensure accuracy in customer service.
• Stay informed about changes in healthcare regulations and industry trends.

Requirements

• High School diploma or equivalent
• 0 years relevant experience

Benefits

• Competitive salary
• Retirement plans
• On-site massages
• On-site counseling via Employee Assistance Program
• Access to Virgin Pulse Wellness tool
• Formal training and career development opportunities