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in Sacramento, CA

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Hours Full-time, Part-time
Location Sacramento, California

About this job

Job Description

Versant Health bringing you Davis Vision and Superior Vision is a leading provider of vision and eye health solutions. We offer a full spectrum of services in the vision care marketplace. Our mission is very real to our members: we help them enjoy the wonders of sight through healthy eyes and vision. What you do as a Versant Health Associate matters. 33 million Americans count on us to provide access to annual eye exams and corrective eyewear. We are here to change the face of vision care, and together we will make this happen.

Great Environment

We are dedicated to you– we provide a professional work environment, competitive benefits, equal opportunities and potential to grow with us. We guide you to what’s right for you- as leaders in the industry, we guide and coach Associates to give them opportunities to reach their full professional potential. We think ahead for you- you’ll enjoy a variety of benefits for those times when you need extra support.

Scope and Purpose of Position

The Customer Service Specialist I is responsible for receiving, answering, and/or resolving calls received through a Call Center. The Call Center receives phone calls from insured’s and their dependents, providers and their staff, employer/group staff, and brokers. The CSS I will use companies Claims / Eligibility database to inquire on the status of claims, ID cards, addresses, and other issues as queried by the caller. The CSS I is the primary source for issuing authorizations when eligible for services. In addition, the CSS I performs duties consistent with customer/provider service.

Essential Functions

  • Provide timely and accurate information to basic incoming customer calls from members, providers, and other external and internal constituents including:
  • Issuing authorizations
  • Handling claim inquiries from providers and members
  • Communicate the correct information regarding accessibility, claims status and other calls of a service nature
  • Providing benefits information
  • Process customer claims according to established department policies and procedures
  • Checking voicemail boxes and handling customer/provider requests for:
  • I.D. cards
  • Authorizations
  • Customer Service questions and issues
  • Fulfill rapid call volume by handling the appropriate amount of calls coming into the call center daily.
  • Complete Provider Relations requests for service
  • Provide timely feedback to the company regarding customer service failures and/or customer/provider concerns
  • Partner with Sales and Provider Relations to meet and exceed customers’ expectations
  • Provide excellent customer service and handle all customers in a professional and courteous manner
  • Perform other related duties as assigned

Education & Experience

  • High school graduate or equivalent is mandatory. Business related college courses preferred.
  • Two years customer service or call center experience.
  • Two years of experience in the health care industry or insurance environment preferred.
  • Strong computer and technical skills to support heavy key data entry.

Competencies

  • Excellent customer service skills (friendly, courteous and helpful)
  • Excellent interpersonal verbal and written communication skills
  • The ability to diffuse volatile situations, share information, and educate callers regardless of customers level of understanding
  • Understanding of the health insurance or insurance industries
  • Strong execution and follow-up skills
  • Goal oriented with ability to meet production standards
  • Team orientation and ability to work effectively across functional areas of the company.
  • Well Organized and resourceful
  • Accurate and efficient data entry skills
  • Strong analytical skill and ability to demonstrate good judgment
  • Ability to coordinate multiple tasks and projects
  • Skilled in dealing with all customers in an efficient and effective manner
  • Bilingual skills helpful

We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, sex, gender identity, sexual orientation, age, marital status, national origin, ancestry, physical or mental disability or history of disability, genetic information, status as a protected veteran or disabled veteran, or any other status protected by Federal, state or local law.

 

If you are prohibited from working on a government contract, this may disqualify you from consideration for this position.

Company Description

Versant Health bringing you Davis Vision and Superior Vision is a leading provider of vision and eye health solutions. We offer a full spectrum of services in the vision care marketplace. Our mission is very real to our members: we help them enjoy the wonders of sight through healthy eyes and vision. What you do as a Versant Health Associate matters. 33 million Americans count on us to provide access to annual eye exams and corrective eyewear. We are here to change the face of vision care, and together we will make this happen.