Customer Service Representative - Medicare
Posted on: January 15, 2022
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable
PacificSource is an equal opportunity employer. All qualified
applicants will receive consideration for employment without regard
to status as a protected veteran or a qualified individual with a
disability, or other protected status, such as race, religion,
color, national origin, sex, sexual orientation, gender identity or
Diversity and Inclusion: PacificSource values the diversity of the
people we hire and serve. We are committed to creating a diverse
environment and fostering a workplace in which individual
differences are appreciated, respected and responded to in ways
that fully develop and utilize each person's talents and
Position Overview: Provide excellent customer service primarily by
telephone to all PacificSource customers. Assist customers with
coverage/claims related questions. Accurately interpret benefits
and policy provisions for all PacificSource products. Conduct
appropriate research and follow-up for prompt resolution of
* Work efficiently in a high volume call center while maintaining a
professional, polite manner.
* Assist callers with coverage related questions; accurately
interpret policy provisions for group and individual business.
* Analyze customer's inquiries and determine steps for resolution,
interpret benefit information, and claims processing accuracy. Keep
resource information up to date and organized.
* Document calls in a clear and consistent manner in computer
* Conduct appropriate research and follow-up for prompt resolution
of disputed claims.
* Relay information to appropriate departments and personnel using
established communication channels and procedures.
* Meet department and company performance and attendance
regulations concerning confidentiality and security of protected
* Perform other duties as assigned.
Work Experience: One year customer service, medical insurance,
other healthcare related field or call center experience
Education, Certificates, Licenses: High School Diploma or
Knowledge: Understand insurance and medical terminology, coding and
standard medical billing practices. Proficient computer skills,
typing, and 10-key required. Medical terminology, CPT/ICD-10 coding
preferred. Bilingual Spanish preferred.
* Building Customer Loyalty
* Building Strategic Work Relationships
* Contributing to Team Success
* Planning and Organizing
* Continuous Improvement
* Building Trust
* Work Standards
Environment: Work inside in a general office setting with
ergonomically configured equipment. Travel is required
approximately less than 5% of the time.
We live and breathe our values. In fact, our culture is driven by
these seven core values which guide us in how we do business:
* We are committed to doing the right thing.
* We are one team working toward a common goal.
* We are each responsible for customer service.
* We practice open communication at all levels of the company to
foster individual, team and company growth.
* We actively participate in efforts to improve our many
communities-internally and externally.
* We actively work to advance social justice, equity, diversity and
inclusion in our workplace, the healthcare system and
* We encourage creativity, innovation, and the pursuit of
Physical Requirements: Stoop and bend. Sit and/or stand for
extended periods of time while performing core job functions.
Repetitive motions to include typing, sorting and filing. Light
lifting and carrying of files and business materials. Ability to
read and comprehend both written and spoken English. Communicate
clearly and effectively.
Disclaimer: This job description indicates the general nature and
level of work performed by employees within this position and is
subject to change. It is not designed to contain or be interpreted
as a comprehensive list of all duties, responsibilities, and
qualifications required of employees assigned to this position.
Employment remains AT-WILL at all times.
Keywords: PacificSource, Springfield , Customer Service Representative - Medicare, Other , Springfield, Oregon
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