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About this job

Exciting career opportunity in Charleston, IL!

Job Summary and Mission

This role of Inbound Customer Service Agent plays a critical role in providing excellent customer service to all customers.

The Customer Service Agent role gives you the benefit of becoming a licensed Insurance Producer in the state of IL. You will take the Illinois Health & Accident Producer Exam and complete the licensing process through the Department of Insurance at NO cost to you. There is a total of 6 weeks of training. Potential to earn $11.50 and beyond. Long term stable career opportunity. This is a full time position, at least 40 hours a week.

Required Knowledge, Skills and Abilities

The ideal candidate must be able to;

  • multi-task
  • ​have 1 year previous customer service experience and/or insurance work experience
  • ability to think quickly
  • problem solve and be productive in a fast paced environment while adapting well to change

Summary of Key Responsibilities

  • Assisting potential new members with the enrollment process and assisting existing members with making changes to their policies. In addition, they will provide Members with their current benefit information, resolve questions concerning claims for medical and prescriptions coverage by occasionally contacting providers and pharmacies, and assist Members with updating account information.
  • Assisting potential new members and existing members of a major health insurance provider with Medicare Part C plans, Medicare Part D plans, Medicare Supplement Plans, and ACA compliant plans.
  • Capturing caller information and sending out pre-enrollment packets or scheduling meetings.
  • Assist potential new members in selecting the health insurance plan that best meets their needs and completing applications.
  • Working with the Federal Marketplace to assist members with enrollment questions and issues
  • Assist existing members in selecting the health insurance plan that best meets their needs for the upcoming year by explaining plan changes and alternative plans.
  • Explaining plan benefits, including verification of provider status and coverage of medications
  • Reviews submitted claims and determine if charges were considered correctly under the subscriber’s benefit plan. If so, explain to the subscriber how the determination was reached. If not, determine what further action needs to be taken.
  • Review subscriber’s Evidence of Coverage and on-line resources to determine how charges will be considered in accordance with their plan. Provides detailed benefit information if procedure / diagnosis code available, general information if not.
  • Assist members with locating in-network providers, pharmacies, and facilities.
  • Assist members with premium questions and acceptance of payments

Qualifications

Must be 18 years of age or older. Background screening and drug test required.