Customer Care Rep II - Fully Remote!

Important things YOU should know: * Fully remote opportunity * Training schedule  8:00am - 4:30pm Monday – Friday CST for the 1st 12 weeks * Work schedule (after training):  Multiple opportunities available with ranging start times from 6:00am CST to 10:30am CST Mon - Fri.   * Hours of operation:  6:00am - 10:00pm CST Monday - Friday so shift could flex based on business need * $2.00/hour differential on Mon/Tues * Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 * Exceptional professional growth in a fun rewarding environment * Experience with Dental or Health insurance a preferred plus   What will YOU be doing for us?    Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience. What will YOU be working on every day?   * Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, * Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. * Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. * Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. * Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances. * Provide updates to providers with questions regarding the status of their credentialing application. * Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. * Ensure all calls are answered according to company and client guidelines. * Accurately document call information and resolution in our internal systems. * Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. * Properly identify issues that need to be escalated appropriately to the leadership team.   Additional Responsibilities: * Provide recommendations on system enhancements and process improvements to management. * Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. * Participate in departmental projects when applicable.   What qualifications do YOU need to have to be GOOD candidate?   Required Level of Education, Licenses, and/or Certificates * High school diploma or equivalent. * Required Level of Experience * 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail.   Required Knowledge, Skills, and Abilities * Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook. * Ability to work occasional overtime as needed. * Excellent listening and communication skills. * Superior customer service skills including the natural ability to provide empathy. * Strong data entry/typing skills. * Strong navigation skills and the ability to multi-task. * Excellent attention to detail. * Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions.   What qualifications do YOU need to be a GREAT candidate? Preferred Level of Experience * 1+ years of job related customer service experience within the dental, vision or medical industry. * Previous experience working in a virtual environment. * Understanding of dental, vision and/or medical insurance terminology. SKYGEN is the trusted partner for specialty benefits payers and government agencies responsible for the delivery and administration of dental and vision benefits. Through cutting-edge technology and service solutions, SKYGEN empowers clients to become the most efficient, effective healthcare organizations in the country.   Equal Opportunity Employer, including Protected Veterans and Individuals with Disabilities.