Support
Salary: Competitive Salary
Job Type: Full time
Experience: Senior Level
ACS Benefit Services, LLC
Bilingual Customer Support Associate (Remote)
Bilingual Customer Support Associate | ACS Benefit Services, LLC| United States
***Candidates must reside in the Eastern or Central US TimeZones. No other time zones or countries will be considered***
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Bilingual Customer Support Associate | ACS Benefit Services, LLC | United States
***Candidates must reside in the Eastern or Central US Time Zones. No other time zones or countries will be considered***
Title:
Bilingual Customer Support Associate
FLSA Status:
Non-Exempt
Shift: Monday – Friday
8:30am to 5pm
37.5 hours per week
Reports to: Customer Support Manager
Department: Medical Claims
Employment Status: Full Time
Supervisory Responsibilities: None
Date Created/Last Evaluated: 2024
Summary
Provide excellent customer service to providers and participants, via Phone, fax and email, while meeting specific metrics. Responsibilities of this position include but are not limited to being logged in and available in assigned phone skills during company operating hours.
Minimum Qualifications
- Graduation from high school or has obtained a General Education Diploma
- 1 or more years of customer service experience, preferred
- Bilingual – fluent in both Spanish and English, spoken and written word
Knowledge, Skills and Abilities
- Computer software proficiency in the following: Word, Excel, Adobe, Outlook, Teams, and Chrome
- Ability to work from home with minimal distractions during work hours
- Excellent verbal and written communication skills, communicating clearly and concisely
- Ability to pay attention to minute details of a project or task
- Must possess time management skills to organize and complete work within given deadlines
- Work independently with minimal supervision.
- Take care of the customers’ needs while following company procedures
- Positive personality and ability to accept constructive feedback
- Ability to get along well with a variety of personalities and individuals
Essential Functions
- Answering customer calls regarding claim status, eligibility and benefit for medical and dental plans
- Document all calls within claims system while on the line with the caller
- Respond to all faxed or emailed correspondence received from participants, providers/PPOs regarding benefits, claim status and payment information
- Faxes or emails medical or dental eligibility/benefits to providers and/or participants.
- Obtain explanations of provider payments (EOPs) from Zelis Payments website and fax/email to providers and participants.
- Determine if procedures require pre-certification with the applicable utilization review vendor
- Trace checks for providers and/or participants handle virtual payment issues with the outside vendors.
- Responds back to the caller with detailed payment information.
- Act as liaison with account managers on PBM/RX issues.
- Act as liaison between Cigna providers and Cigna.
- Inform manager regarding verification of benefits (VOB) enhancements or corrections that are needed
- Create tickets for disputes or appeals with Cigna
- Assist participants with finding a participating provider on applicable network website
- Report any issues, concerns, ideas or recommendations in the department Customer Service Manager
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. This role routinely uses standard office equipment such as computers and phones. This is a sedentary role.
Work Environment
This job operates in a work-from-home environment which requires a dedicated workspace with minimal distractions
