Rose International INC Call Center Specialist in Maryland Heights, Missouri

Position Title: Call Center Specialist

Position Number: 300095

Location: Maryland Heights, MO

Desired Skill Set:

Customer Service, Healthcare, Microsoft Office, Payment Processing, Typing

Position Description:

C2C and STEM-OPT are not available

Only U.S. Citizens and those authorized to work in the U.S. can be considered as W2 candidates.

Client - Lumeris

Title- Customer Service Representative

Location: Maryland Heights, MO

Job Description Summary

As a Customer Service Representative, you will: directly respond to questions, handle issues and provide guidance on transactions, inquiries or complaints from both internal and external customers. External customers would include Essence’s members and providers. Receive, document and resolve customer inquiries by using established best practices. Build lasting relationships with Essence’s members. Educate members and providers about Essence’s products and services over the telephone.

Role and Responsibilities:

• Respond to complex customer calls.

• Resolve customer service inquiries which could include: ?Benefit and Eligibility information

• Billing and Payment issues

• Customer material requests

• Physician assignments

• Authorization for treatment

• Explanation of Benefits (EOB)

• Must be able to handle volatile situations and act urgently when necessary.

• Must be willing and able to work flexible hours, including some weekends during specific times of the year and over time when needed.

• Makes outbound calls to any source needed to resolve open issues including but not limited to members, providers, pharmacies, hospitals etc.

• Issue form letters & forms, when appropriate.

• Investigates and respond to general correspondence, which may result in a variety of additional actions.

• Must have strong investigative, problem solving skills.

• Must be very detailed oriented and organized.

• Ability to read and comprehend instructions in a very changing environment.

• Ability to interact with other departments i.e. Enrollment, medical management in resolving issues.

• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications.

Experience, Qualifications and Education:

• High school diploma or general education degree (GED).

• Minimum of 2 years Health Care/insurance experience.

• Proficiency in all Microsoft Office Programs, including Word, PowerPoint, Excel, and Access.

• Ability to type 30-45 wpm.

• Prior Customer Service & Claims adjudication experience in the health care field along with working knowledge.


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Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify).

(Posting required by OCGA 13/10-91.)