For nearly 40 years, CoreSource has been delivering customized employee benefit administration services to self-funded employer groups across the United States.  Each of our offices around the country is managed locally by industry veterans who understand the dynamics of the markets they serve.  Every office delivers the personal attention of a TPA, backed by the resources and innovation of a large national organization, The Trustmark Companies.  #GD

CoreSource is seeking a dynamic and passionate Customer Service Representative in our Sterling Heights, Michigan office.  The Customer Service Representative is responsible for working with clients, participants and providers to accurately and respectfully respond to telephonic, written and electronic inquiries.  Inquiries include a variety of topics such as benefits, eligibility, claim status, claim disposition and so on.   The emphasis is on exceptional service, exceeding customer expectations.

KEY ACCOUNTABILITIES

• Responds to telephone, written and electronic inquiries from employees/members, providers, clients and other interested parties using system notes, plan documents and booklets, benefit reference documents, Claim Reference Manuals and claims-related memoranda.
• Treat all inquiries professionally and respectfully following CoreSource guidelines.
• Appropriately refer or escalate calls based on customer service procedures and guidelines.
• Research inquiries and respond appropriately.
• Appropriately refer unresolved inquiries or inquiries requiring further action to the appropriate individual, i.e., Analyst, Corrections, Senior, Supervisor/Manager.
• Follow up regularly on outstanding issues to ensure timely resolution and client satisfaction.
• Thoroughly and accurately document all inquiries using proprietary systems following CoreSource guidelines.
• Communicate via telephone, email, electronic messaging, fax or written letter with employees/members, providers of service, clients and/or other insurance carriers to ensure proper claim processing and issue resolution.
• Initiate outgoing calls or other service projects as needed.
• Other duties as needed/assigned.

EXPERIENCE & EDUCATION

• Prior experience in a fast-paced call center preferred
• High School diploma or GED equivalent
• Previous customer service experience
• Ability to work in a fast-paced, customer focused environment
• Excellent verbal communication skills
• Effective written communication skills
• Ability work effectively with team members, employees/members, providers and clients
• Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvement
• Ability to learn new/proprietary systems, to adapt to various system platforms
• Proficient in MS Excel/Word/Outlook
• Self-funded insurance/benefits and/or TPA experience preferred
• Knowledge of medical procedure and diagnosis coding preferred
• Familiarity with Summary Plan Descriptions (SPDs)/insurance booklets or other benefit descriptive tools preferred

EOE/Minorities/Females/Protected Veterans/Disabled

Required Skills Required Experience