Humera - Administrative and Professional Staffing

Customer Service Representative III

Minnetonka, MN, USA
Contact For Rate
Feb 19, 2017
Feb 22, 2017
Job Type
Employment Status
Full Time
Humera is seeking multiple Customer Service Representative III's for our client, a major healthcare provider, in Minnetonka, MN. Candidates in these positions will be responsible for managing all inquiries from active, terminated, and prospective health insurance members. They will resolve service problems for claims, enrollment, billing, pharmacy as well as interpreting contracts and explaining benefits. They are responsible for exceptional levels of service satisfaction, providing quality service, and the service recovery process. The service recovery process is critical to the success of the department.
    Advancement opportunities are moderate to high. After mastering the position and performing at above standard levels, this Customer Service role could move into higher position. You could move into a Lead, Issue Resolution Analyst, Client Specialist, Quality Administrator, Consumer Affairs Advisor or supervisory position within the department or other departments. Manager positions may be available in Customer Service, Provider Service Center, Special Investigations Unit, Claims Analysis and Recovery, Electronic Commerce and Project Management. A technical route may include IT Service Desk, Business Analyst and Electronic Commerce Specialist positions.
    The Customer Service Representative III is responsible for identifying, researching and resolving member and all other internal and external customer concerns, problems and issues in a timely and courteous manner. Customer Service Representative are expected to work with enrollment, billing and other departments within the company to resolve member issues. Customer Service Representative typically interact with a number of external and internal customers. External customers include the following: active, terminated, and prospective customers (providers and third-party administrators). Internal customers include: employees in medical management, enrollment, billing, claims, sales/marketing and legal. Outside vendors may include: pharmacy benefits managers, behavioral health and dental providers.
    • 1-2 years customer service experience required
    • Associate's degree or equivalent work experience required. Bachelor's degree preferred
    • Critical thinking, problem solving and the ability to deescalate calls
    • Excellent verbal and written communication skills
    • Ability to toggle between computer screen and applications

    • 6 weeks of training. Hours are (8:00am - 5:00pm) for training with a 1 hour lunch
    • Regular Hours: 9:30am - 6:00pm with a 30 minute lunch