Healthcare Customer Service Job Description

Healthcare Customer Service Job Description

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Healthcare customer service provides advice and recommendations to leadership in the development, implementation, and evaluation of new or modified operating policies, practices, and procedures within the specified functional area of focus.

Healthcare Customer Service Duties & Responsibilities

To write an effective healthcare customer service job description, begin by listing detailed duties, responsibilities and expectations. We have included healthcare customer service job description templates that you can modify and use.

Sample responsibilities for this position include:

Manage customer disputes and issues in a positive manner
Interacts effectively with the Operations team, business partners, and internal departments
Identifies opportunities to improve processes and services
Interacting with members who may have serious chronic conditions, physician practices, insurance carriers, health plans, and pharmacy operations team members
Answering inbound and outbound calls
Route calls to appropriate department(s)
Entering accurate information into a multi-screen computer application
Assisting pharmacy services staff members with answering phones, triaging calls, filing and other administrative support activities
Engages in both inbound and outbound voice and chat
Uses client-based email in work

Healthcare Customer Service Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Healthcare Customer Service

List any licenses or certifications required by the position: CEGEP, LPN

Education for Healthcare Customer Service

Typically a job would require a certain level of education.

Employers hiring for the healthcare customer service job most commonly would prefer for their future employee to have a relevant degree such as Collage and High School Degree in Education, Healthcare, Associates, Communications, Business/Administration, Business, Computer Sciences, Medical, Technical, Marketing

Skills for Healthcare Customer Service

Desired skills for healthcare customer service include:

Products
Client focus groups
Formal training
Important issues through management communications
Meetings
Pricing
Procedures
Computer operations
Functional area and company policies and procedures
Medical terminology

Desired experience for healthcare customer service includes:

Ability to communicate with consumers, demonstrate great active listening skills, research/troubleshoot the inquiries, educate consumers and document results
Demonstrated proficiency in Microsoft Office Word, Outlook, Internet and other software’s
Customer Service, Healthcare or Pharmaceutical experience highly preferred
If you meet the requirements of the customer service position and want to work for a world-class company with a great marketplace reputation, apply today!
1-3 years in a customer call center service environment
Effective and diplomatic oral communication skills

Healthcare Customer Service Examples

1

Healthcare Customer Service Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of healthcare customer service. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare customer service
  • Not required to maintain average handle time (AHT) of less than five minutes
  • May require follow up with customers on requested leads
  • Required to meet sales targets
  • Relies on multiple tools
  • Probe for and confirm understanding of customers issue and needs
  • Confirm customer understanding of the solution
  • Provide additional customer education as needed
  • Contribute ideas to better resolve problems, serve the customer, and improve productivity
  • Solve problems that are sometimes unstructured and require reliance on conceptual thinking
  • Manage oral and written correspondence (letter / fax / e-mail), with special attention to quality of the message and the time of response
Qualifications for healthcare customer service
  • Demonstrates cultural competence
  • College level experience preferred
  • 1+ years of call center customer service experience or 2+ years of customer service experience
  • Preference in a healthcare or insurance environment
  • Proficiency with computers and use of productive software to complete tasks (MS Office Suite, Project Management tools and other applications)
  • 3+ years leading claim/ managed healthcare customer service team
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Healthcare Customer Service Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of healthcare customer service. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for healthcare customer service
  • Anticipate and assess client needs and communicate your findings internally
  • Responsible for tasks such as, but not limited to, basic data input of claim fees in Mainframe (internal system)
  • Conduct effective consultative selling by asking appropriate questions and matching the right product to the customer’s needs, resulting in closed sales increased customer satisfaction
  • Conduct effective consultative selling by asking appropriate questions and matching the right product to the consumer’s needs, resulting in closed sales increased consumer satisfaction
  • Researches and analyzes problems and provides information and solutions
  • Operates computer to obtain and extract information, documents information, activities and changes in the database
  • Receives and places follow-up telephone calls and emails to answer customer questions that are routine in nature
  • Demonstrate awareness, motivation, and technical skills to assist in the development and growth of the contact center teams and help to identify process improvements
  • Assist in department/company projects, as needed
  • Assess all in-bound calls to accurately and efficiently address caller’s needs
Qualifications for healthcare customer service
  • 3+ years experience with claim/call center environment
  • Must have Behavioral Health Precertification experience required
  • Strong organizational, time management and task management skills and experience
  • Must have Project Management skills (financial, analytical, planning and implementation)
  • Customer Service/Customer service - production environment/1-3 Years
  • Leadership / Coaching/ Mentoring/2-4 Years
3

Healthcare Customer Service Job Description

Job Description Example
Our company is searching for experienced candidates for the position of healthcare customer service. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for healthcare customer service
  • Customer Focus—Dedicated to keeping customers in mind, establishes and maintains effective relationship with customers and gains their trust and respect
  • An attractive compensation package including medical, dental
  • Update provider status and information in the case management system as directed by the client
  • Perform file uploads and create new records in the case management system
  • Upload application documents and forward electronic faxes to the appropriate team
  • Complete initial review and verification of application documents, as needed
  • Provide customer service for phone inquiries and assist with completing callbacks
  • Draft and send letters to providers requesting application documents, using notes documented in the provider application
  • Respond to non-phone customer inquiries (e.g., mail, e-mail, and fax)
  • Receive inbound customer care phone calls
Qualifications for healthcare customer service
  • Call Management/CMS/1-3 Years/Power User
  • Professional fluency in English and Spanish (must read and write Spanish)
  • Experience in the Healthcare/Health Insurance Industry is strongly preferred
  • Minimum of two years experience in call center customer service
  • Good understanding of modern supply chain processes
  • Knowledge on systemized data processing and process controls
4

Healthcare Customer Service Job Description

Job Description Example
Our company is searching for experienced candidates for the position of healthcare customer service. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for healthcare customer service
  • Quickly understand and analyze customer needs and use computer based software to properly service the customer needs
  • Provide an exceptional customer service experience
  • Respond with empathy to complaints and concerns from members
  • Initiate contact to obtain information relevant to the concern or inquiry as needed and follow-up as necessary to ensure that no tasks slip through the cracks
  • Be open and receptive to feedback, and be willing to change behavior to improve performance
  • Maintain service and product knowledge
  • Talking to members and providers over the phone (inbound calls)
  • Maintain and updates customer information as necessary
  • Processing of Claims and Benefits through Computer Systems
  • Explain basic coverage details and route inquiries to the correct department as needed
Qualifications for healthcare customer service
  • Ability to receive inbound calls and effectively professionally communicate with consumers providing an excellent customer service experience
  • Behavioral Health Pre-certification / 2-4 Years
  • Experience in working in FMCG environment
  • Fluency in spoken and written French, Dutch& English
  • Knowlegde of current software (MS Outlook, Word, Excel, SAP (O2C module)
  • Service attitude / Customer minded
5

Healthcare Customer Service Job Description

Job Description Example
Our company is growing rapidly and is looking for a healthcare customer service. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for healthcare customer service
  • Maintain a strong working knowledge of client processes
  • Support the team through strong attendance and performance
  • Effectively manage large amounts of incoming calls, orders and enquiries
  • Identify and assess customers’ needs to achieve customer satisfaction
  • Build sustainable relationships of trust through interactive communication, service consistency and positive outcomes
  • Proactively provide accurate, valid and complete information to customers
  • Contribute to the continuous improvement of the services provided to our customers
  • Communication with Sales, Marketing, Demand Planning, Warehouse and Transport as required achieving desired outcome for the customer
  • Display and evoke the values of Sanofi Consumer Healthcare
  • Manage train & guide the Customer Service Team on a day to day basis
Qualifications for healthcare customer service
  • Possess a drive to achieve insight into self and others
  • Work experience in office preferred, excelling in customer service
  • Fluent bilingual, English and Spanish preferred but is not a requirement
  • 1 year of Healthcare Custmomer Service experience
  • Fast learner with new information and new software skills
  • At least 2 years in college or have completed an Associate Degree preferably in paramedical field

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