About the Role
Evry Health, a Globe Life company, is seeking a Call Center Representative. Call Center Representatives provide accurate and thorough information on plan benefits, eligibility, and claims.You will handle inbound and outbound calls as well as respond to email inquiries from our customers. In this role, you may be responsible for developing process, call scripts, metrics, and desk top procedures. The role is responsible to deliver an exceptional customer service experience to our Evry members and providers. This role reports to the Sr. Director Claims and Customer Support and Manager of Claims and Customer Support.
About Evry Health and Globe Life
We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives.
Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.
Key Responsibilities
- Research, reviews and responds to inquiries received from members and providers.
- Employs active listening skills, demonstrates patience and empathy, and can handle difficult calls tactfully, courteously and professionally.
- Effectively manages escalations within the department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure.
- Leverages company policies and procedures, benefits, claims, and eligibility to respond accurately to all inquiries.
- Handles member complaints and complaint appeals.
- Works with internal departments, vendors, business partners, providers, etc. to help coordinate problem solving in an effective and timely manner.
- Demonstrates basic understanding of company billing guidelines and can effectively interpret inquiries related to claims and claim payments.
- Accurately documents all calls.
- Recognizes trends and patterns in call types and engages leadership with suggested solutions.
- Accountable to meet and maintain established department production and quality standards, on both an individual and team basis.
- Assists members with navigating the member portal while encouraging them to becoming self-sufficient with our tools.
- Demonstrates personal responsibility and accountability by meeting attendance and schedule adherence expectations.
- Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1:1s, Instant Messaging, or check-ins.
Experience and Skills Desired
- You have a minimum of 2 years customer service experience.
- You have knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes.
- You are an excellent communicator, both verbally and in writing and can articulate and communicate complex topics to a broad audience.
- You can perform comfortably in a fast-paced, deadline-oriented work environment.
- You possess strong attention to detail and problem- solving skills with a high level of accuracy.
- You collaborate and support business and operational units such as Claims, Medical Management and Appeals and Grievance.
- You are proficient in Microsoft Office applications Word, Excel, Outlook OneNote, etc.
- You have prior experience using a CRM, preferably SalesForce.
- Bonus: fluency in Spanish.
Telecommuting Requirements
- Required to have a dedicated work area established that is separate from other living areas and provides information privacy.
- Ability to keep all company sensitive documents secure.
- Must live in the United States.
- Must live in a location that receives an existing high-speed internet connection/service.
Location and Benefits
- This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.
- Company business hours are weekdays 9-5 CST.
- Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Employment Status
Full time – Salary.
Shifts
Business hours.
Minimum Required Education
High School graduate
Experience
Minimum of 2 years call center experience in a health plan or managed care environment is required.
