Job Description

Job Description

Job Description

Summary: This is a high volume inbound Call Center. The main function of an SCA call center/customer service specialist is to interact with customers to provide information in response to inquiries about benefits and coverage and to handle and resolve complaints. 
Job Responsibilities: -
Provide responses to mostly providers, minimal members who have called the provider line in error for some of the following reasons (not an inclusive list):

• Claim status or explanation.
• Eligibility
• Verification of benefits
• Authorization explanation or review
• Overpayment status
• Collection or Off set status (recovering overpayment by withholding future payments)
• Provider contract status and outstanding items
• Fees for services
• General information such as addresses or phone numbers for additional support when they have not reached the correct line.
  • All calls will be electronically documented following their process using C-notes (Call notes)

In addition to the above call types, this role will work with multiple platforms and applications to secure necessary information for the call. Some examples of these would be (not an inclusive list):

• Humana’s system and authorizations
• WPS Fees schedule system
• Ollie which is where they house very detailed instructions.
• Facets for research and documentation

Experience needed:
Previous experience with computer applications, such as Microsoft Word and PowerPoint.
Education/Experience: - High school diploma or GED preferred. –
2-4 years customer service related experience required.

The Jacobson Group is the leading provider of insurance talent. For more than 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.

Company Description

The Jacobson Group is the leading provider of insurance talent. For more than 50 years, we have been connecting insurance organizations with professionals from the board room to the back room on both a permanent and temporary basis. We offer a variety of solutions including executive search, professional recruiting, temporary staffing, subject matter experts, and onsite and work-at-home operations support. Regardless of the need or situation, Jacobson is the insurance talent solution.

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