Provides timely and accurate information in response to incoming telephone inquiries using an automated telephone system, computer applications, training material and other applicable resources. Resolves member complaints regarding coverage, claims and service, and documents outcomes for future reference. This includes clarifying members complaints, investigating the problem, developing solutions, making recommendations to management, and following-up to ensure resolution. Works with the carrier to process claim adjustment requests and cheque stop-payments, and reissues requests related to claims adjudication issues, while ensuring decisions are made on a timely basis. Identifies trends in claim adjudication errors and problems. Responds to member email inquiries from the departments email queue within specified department turnaround times. Provides information in response to inquiries from members and other departments regarding coverage, effective dates and outstanding information, as requested. Ensures a high level of customer satisfaction through effective support and excellent customer service, by providing quick and accurate service in a professional manor. Drafts letters and prepares and processes responses to routine correspondence, while adhering to established standards. Applies proper contractual provisions in accordance with related contracts and carrier requirements to determine member eligibility for requested benefits.
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Employement Category:
Employement Type: FreshersIndustry: ITESFunctional Area: Customer ServiceRole Category: Customer Service Executive (Voice)Role/Responsibilies: Call Center Job For Freshers