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Customer Service Representative

Pittsburgh, PA | Job #: 19-00884

Seeking experienced Customer Service Associates for a large, Fortune 100 Health Insurance company in Pittsburgh, PA!

  • Helps our customers maintain their health, well-being, and sense of security by managing an assigned caseload of disability claims under guidance.
  • Evaluates customer eligibility based on contractual, state, and federal guidelines; communicates decisions in writing, calculates, and issues benefit payments.
  • Follows-up on and reviews Social Security decisions and other income benefits.
  • Helps customers through difficult times by following-up on their medical progression and discussing return to work options.
  • Partners with medical, vocational, and other expert resources to develop a plan to address disability obstacles between the customer, attending physician, and client to facilitate a successful return to work on a full-time or modified-duty basis.
  • Determines customer eligibility by reviewing contractual language and medical documentation, interprets information and makes decisions based on facts presented

Skills:

  • Exceptional customer service standards and delivery
  • Strong oral and written communication skills
  • Ability to prioritize and multi-task
  • Ability to thrive in a fast-paced environment and meet deadlines
  • Strong math and calculation skills
  • Excellent interpersonal, organizational, negotiation, investigative, analytical and research skills
  • Conflict resolution skills and Critical attention to detail
  • Proficient in Microsoft Office
  • Multilingual skills are highly desired

Education:

High School Diploma Required
BA/BS degree or equivalent work experience Preferred
Minimum of 1 year disability claim management experience preferred

 

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