Job Description
Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths. Provide excellent customer service primarily by telephone to all PacificSource customers. Assist customers with coverage/claims related questions. Accurately interpret benefits and policy provisions for all PacificSource products. Conduct appropriate research and follow-up for prompt resolution of disputed claims. Essential Responsibilities: Work efficiently in a high volume call center while maintaining a professional, positive, and caring demeanor. Assist callers with coverage related questions/concerns; accurately interpret policy provisions for assigned products. Analyze customer’s inquiries and determine correct steps for resolution, interpret benefit information, and claims processing accuracy. Keep resource information up to date and well organized. Work efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem solving skills. Document calls in a clear and consistent manner in computer system. Conduct appropriate research, take ownership and follow through for prompt resolution of disputed claims. Relay information to appropriate departments and personnel using established communication channels and procedures. Make outbound calls to
