Health Insurance Customer Service Representative

Killeen, Texas
Administrative & Support Services (Office and Administrative Support Occupations)
Job Type
Working Hours
7:00 AM - 8:00 PM (Various Shifts Available)
US$ 12.00 per hour
Ref. Number
Kemery, Jennifer, Spherion
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Job Description

The Health Insurance Customer Service Representative is responsible must be able to multi-task, have previous customer service experience/insurance work experience, and ability to think quickly, problem solve and be productive in a fast paced environment while adapting well to change.

The ideal candidate is responsible for assisting existing members with their current benefit information, resolve questions concerning claims for medical and prescriptions coverage by occasionally contacting providers and pharmacies, and assist Members with updating account information.

Working hours: 7:00 AM - 8:00 PM (Various Shifts Available)

--Assisting potential new members and existing members of a major health insurance provider with ACA compliant plans
--Working with the Federal Marketplace to assist members with enrollment questions and issues
--Explaining plan benefits, including verification of provider status and coverage of medications
--Reviews submitted claims and determine if charges were considered correctly under the subscriber's benefit plan. If so, explain to the subscriber how the determination was reached. If not, determine what further action needs to be taken
--Review subscriber's Evidence of Coverage and on-line resources to determine how charges will be considered in accordance with their plan. Provides detailed benefit information if procedure / diagnosis code available, general information if not.
--Assist members with locating in-network providers, pharmacies, and facilities
--Assist members with premium questions and acceptance of payments

High School

1-4 years

??? Good written and verbal communication skills
??? Solid customer service skills
??? Ability to multitask and use multiple complex systems on multiple platforms
??? Ability to look at complex issues and identify the problem using multiple systems
??? Ability to remain calm under pressure and handle upset callers
??? Active listening skills and ability to ask clarifying questions to gain understanding
??? Problem solving skills

Please call today to discuss future opportunities!

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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