REMOTE CUSTOMER SERVICE REPRESENTATIVE II (CLAIMS PROCESSING): Full Time

JOB OVERVIEW:

As a Remote Customer Service Representative II (Claims Processing), you will be responsible for the accurate review, data entry, and processing of claims from your home, with company-provided equipment. The Remote Customer Service Representative II (Claims Processing) provides superior customer service for a specific contract in support of a customer with high demands for privacy, confidentiality, precision, advanced technology, and customer service skills. This is a full-time position. If you are detailed-oriented, enjoy working in a fast-paced environment, and are passionate about helping others, please apply today.

WHY WORK FOR SAVILINX?

At SaviLinx, we help people! It’s not just our job; it’s our mission. Founded in Maine in 2013, SaviLinx is a Women Owned and HUBZone-certified contact call center that has been named to the Inc. 5000 list of fastest-growing companies for five consecutive years.

JOIN THE SAVILINX FAMILY AND YOU’LL ENJOY:

Medical, dental, life, vision, 401(k) with company match, pet insurance, and paid time off.
Very competitive wages and additional pay for performance.
100% paid training
Opportunities for advancement and professional development.
All work equipment provided by SaviLinx.

ESSENTIAL JOB FUNCTIONS:

Demonstrates ability to work in accordance with the Savilinx Guiding Principles.
Supports the day-to-day processing of claims for a contract with the following duties.
Acknowledges establishment of new claims assigned daily.
Accepts telephone calls from claimants.
Adjudicates claims within guidelines ensuring the benefit eligibility is correctly determined.
Researches and resolves escalated and complex claim issues in a timely manner.
Reviews supporting documentation for accuracy.
Connects with applicants to guide them through the claim process.
Maintains and follows-up on pending files, as required by guidelines.
Practices all policies and procedures to PHI and HIPAA.
Documents all claimant information, communications in CRM system.
Ensures privacy, confidentiality, and precision with all work.
Maintains a working knowledge of our clients’ requirements.
Regular and consistent attendance is an essential function of the job.

OUR GUIDING PRINCIPLES:

Make every interaction Count
Act with Respect and Integrity
Demonstrate Passion for Continuous Improvement
Be Worthy of Trust from all Stakeholders

SUPERVISORY RESPONSIBILITY:

This position has no supervisory responsibility.

EXPECTED WORKDAYS/ HOURS:

Typical work hours are 8 a.m. to 5 p.m. Monday through Friday

QUALIFICATIONS:

Education: High school diploma or equivalent is required. College degree preferred.
18 years or older
Time management skills and working independently are essential for this role.
Excellent organizational, written, and oral communication skills.
Computer proficiency and ability to navigate multiple computer screens and programs while talking with a customer.
Customer-service oriented (empathetic, responsive, patient, and conscientious)
Experience with maneuvering electronic data between various environments.
Prior experience with PHI or HIPAA is preferred.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

PHYSICAL/ENVIRONMENTAL DEMANDS:

Sedentary work that primarily involves sitting/standing. General, office (or home office) environment.
The physical demands described here represent those that must be met by an employee to perform the essential functions of this job successfully.
Remaining in a stationary position, often standing or sitting for prolonged periods of time.
Adjusting or moving objects up to 15 pounds in all directions.
Communicating with others to exchange information.
Repeating motions that can include the wrists, hands, and/or fingers.

EQUAL EMPLOYMENT OPPORTUNITY

SaviLinx, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

EOE/VETERAN/DISABLED

Experience

• 1 year(s): Customer Service