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