Customer Service Representative

Join a team that delivers excellence.

Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.

Join our team and experience firsthand what it's like to be part of a health care organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.

Imagine a career at one of the nation's most advanced health networks.

Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.

LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region.

Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety.

These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.

Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.

Summary

Supports a positive service experience while handling member and provider inquiries via telephone, Customer Service portal, or written correspondence.

Job Duties

Performs ancillary customer service functions relative to claims, providers, recoveries, and forms or letter generations.

Uses multiple systems and screens to efficiently handle interaction.

Offers solutions that aid and facilitate a unique customer service experience, including First Call Resolution (FCR). Anticipates needs;

educates members and providers about related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.

• Engages caller to gather necessary information to guide through plan of benefits, answer questions regarding care needs, and resolve issues.
• Interacts with customers, vendors, and colleagues professionally to ensure questions are answered accurately and in a timely manner.
• Assists with billing questions, claim adjustments, FSA / HSA account, COBRA payments, etc.
• Handles requests related to appeals and pre-authorizations.
• Meets all quality and adherence standards.
• Participates in team and individual discussions related to process improvement.

Minimum Qualifications

• High School Diploma / GED
• 2 years Call center experience and
• 2 years Insurance and / or claims administration experience
• Ability to take the initiative to identify and carry out responsibilities to their completion.
• High degree of professional judgement and inter-personal skills at all levels and among all disciplines.
• Knowledge of insurance or claims administration.

Physical Demands

Lift and carry 7 lbs., continuous sitting >

67%, frequent keyboard use / repetitive motion, frequent fine motor activity / wrist position deviation.

Job Description Disclaimer : This position description provides the major duties / responsibilities, requirements and working conditions for the position.

It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs.

Other responsibilities may be assigned when circumstances require.

Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law.

All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and / or social activities.

Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location.

Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes.