One of our client Looking for Customer Sucsess Manager Role for insurance and health benefits platform dedicated to simplifying healthcare for modern organizations. As a member of the Strategic Accounts Servicing Team, you will play a crucial role in delivering streamlined and efficient claims management for our key strategic accounts, ensuring timely resolution and exceptional service that fosters client trust and satisfaction.
Key Responsibilities:
- Act as a dedicated Claims Buddy, managing end-to-end cashless and reimbursement claims for employees, ensuring a seamless experience.
- Verify policy coverage by meticulously reviewing policy details to confirm claim eligibility based on the insurance policy's terms and conditions.
- Provide exceptional customer service by promptly responding to inquiries from customers and stakeholders regarding claim status and related queries via phone and email.
- Coordinate with healthcare providers and insurance companies to obtain necessary information and clarify details, ensuring accurate claim processing.
- Investigate and resolve discrepancies, errors, or issues that arise during claim processing to ensure timely and accurate resolution.
- Collaborate with internal stakeholders, HR representatives from client accounts, and employees to deliver a positive and seamless claims experience.
- Proactively communicate with employees regarding the status of their claims, keeping them informed throughout the process.
- Maintain detailed and accurate records of all claim-related activities, communications, and transactions for comprehensive documentation and audit purposes.
- Adhere to established service level agreements (SLAs) and performance metrics related to claim processing, turnaround time, accuracy, and customer satisfaction.
- Strive to achieve a Net Promoter Score (NPS) of 90+ for the claims you handle, demonstrating a commitment to exceptional service.
Required Qualifications:
- Minimum of 2 years of experience in customer-facing roles, demonstrating strong interpersonal and communication skills.
- Proven ability to effectively manage and resolve customer inquiries and issues.
- Excellent communication skills, both written and verbal.
- Strong organizational and time-management skills, with the ability to prioritize tasks and meet deadlines.
- Ability to work effectively both independently and as part of a team.
- Proficiency in using computer systems and software applications for data entry and record keeping.
- Strong problem-solving skills and attention to detail.
Preferred Qualifications/Good to Have:
- Previous experience in a voice-based customer service role.
- Experience with cashless claims processing and Third-Party Administrators (TPAs).
- Knowledge of health insurance policies and claims procedures.
What Makes This Opportunity Attractive:
- Impactful Role: Directly contribute to enhancing the healthcare experience for employees of strategic client accounts.
- Growth Potential: Opportunity to develop expertise in claims management and customer service within the health insurance industry.
- Collaborative Environment: Work alongside a dedicated team of professionals committed to delivering exceptional service.
- Continuous Learning: Expand your knowledge of health insurance policies, claims procedures, and customer service best practices.
