[Hiring] Customer Service Representative @Versant Health

Role Description

The Customer Service Representative I responds to customer service inquiries including, but not limited to, benefit information and timely fulfillment of requests for Versant Health Membership, Providers, and Client Representatives. Additionally, this role acts as a liaison with internal and external Versant Health business partners to provide exceptional customer service experience.

• Provide exceptional customer service while answering incoming Member and Provider telephone inquiries in a respectful and courteous manner.
• Utilize proprietary systems to respond to customer inquiries and requests, adhering to defined customer service standards (i.e. knowledge of in/out of network co-pays, non-plan allowances/retail value as well as the various network relationships).
• Act as a liaison coordinating efforts between Member, Provider, Client Representatives and the manufacturing facilities.
• Identify and perform requirements related to specialty services including but not limited to student proof, prior approval, medically necessary contacts, special voucher/authorization processing, and requesting enrollment cards as well as out-of-network requirements and/or order entry.
• Shadow perspective associates and new associates during initial instruction, including providing feedback to the hiring management team and trainer.
• Probe and identify the critical content of inquiries and route callers as appropriate; achieve and maintain individual Key Performance Indicators (e.g. quality, adherence to schedule) at acceptable departmental levels while supporting organizational performance measures.
• Perform in adherence to the company core values including but not limited to privacy, confidentiality, and proprietary company policies and procedures (i.e. HIPAA).
• Participate in any training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals, as well as the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements.
• Review educational notifications and remain current on procedural changes.
• Maintain flexibility in work schedule as business needs require.
• Perform additional duties as assigned.

Qualifications

• Education: Associates Degree preferred; High School diploma or GED required.
• Experience: 1 Year required; 1 year of related experience required.
• Proficiency in Microsoft Office applications required.
• Knowledge and experience in the insurance, health, or vision care industry preferred.

Requirements

• Competencies:
• Communication: Communicates clearly and effectively.
• Service Focus: Demonstrates a strong commitment to customer and stakeholder satisfaction.
• Technical Capacity: Demonstrates the ability to effectively use tools, systems, and technology relevant to the role.
• Business Acumen: Understands the organization's goals and applies sound judgement to align work with strategic priorities.
• Quality of Work: Maintains strong attention to detail, ensuring accuracy and consistency in all work.
• Essential Responsibilities related to Physical Demands/Work Environment:
• The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
• While performing the duties of this job, the associate is required to stand, use hands and fingers to handle, feel, pick or pinch, and talk or hear most of the time.
• The associate is occasionally required to stand, walk, and reach with hands and arms.
• The associate must frequently lift and/or move up to 20 pounds.
• The noise level in this location is moderate (use of computers, printers and machines).
• Ability and willingness to travel as required.
• HIPAA & Security Requirements: All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.

Benefits

• Comprehensive and competitive total rewards package designed to support your health, financial well-being, and work-life balance.
• Medical, dental, and paid vision coverage.
• Paid time off and company holidays.
• Retirement savings with employer contribution.
• Employee wellness resources.
• Professional development opportunities.
• Additional benefits may include flexible work arrangements, employee assistance programs, and other programs that support you both at work and beyond.