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Customer Service Representative, Healthcare

Community Health System
locationFresno, CA, USA
PublishedPublished: 6/14/2022
Full Time

Job Description

Job Description

Overview

Opportunities for you!

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek
  • Free Continuing Education and certification
  • Tuition reimbursement, education programs and scholarships
  • Vacation time starts building on Day 1, and builds with your seniority
  • Free money toward retirement with a 403(b) and matching contributions
  • Great food options with on-demand ordering
  • Free parking and electric charging

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care is through taking care of our incredible teams. Learn more on our Benefits page.


Responsibilities

The Customer Service Representative (CSR) is responsible for providing effective customer service to members, providers, and other authorized representatives. The CSR responds to health plan inquiries, answering questions regarding plan benefits, claims, billing, and eligibility. This position requires excellent telephone oral and written communication skills, and attention to detail when documenting applicable call notes.Day in the Life:

The Customer Service Representative team handles roughly 120 to 190 inbound calls per day from both members and healthcare providers. Core daily tasks include:

  • Verifying member benefits and eligibility.
  • Providing claim status updates.
  • Providing status updates for prior authorizations.


Qualifications

Education

  • High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required

Experience

  • 1 year of commercial health plan or insurance experience preferred
  • Experience providing customer service in a health care environment preferred
  • Trizetto / QNXT software experience preferred
  • Previous TPA experience is preferred (the position will support TPA services).
  • Experience with Excel