Customer Service Representative

Kforce Finance and Accounting
September 29, 2021
Denver, CO
Job Type



Kforce has a client in Denver, CO that is seeking a Customer Service Representative. The Customer Service Representative is responsible for increasing customer satisfaction and retention by providing members, customers, patients, and providers with accurate, consistent, timely and meaningful information. This role will provide support to member's inquiries and issues as they utilize the company plan and provider services, continuing to build rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines.

The Customer Service Representative will be available to handle member inquiries regarding:

  • Member Core: Facility Inquiry, Web Support, Promote company website, Order ID Card, Complaint, ID Card Inquiry, Service Review
  • Member Advance: Eligibility Inquiry, Benefit Inquiry, General, Complaint, Correspondence Inquiry, Add/Remove Dependent, Service Review, New Member Experience, Internal Regional Request, IVR Defaults
  • Medicare (For up to two (2) regions)
  • Premium Billing Enterprise: Billing Inquiry, Make Payment, Complaint, EFT Inquiry, General, Reinstatement Request, Service Review
  • Company Billing, 1095 Tax Form, SLP (escalations to Tier 3)

Additional duties:

  • Represents Health Plan by answering and documenting all incoming contacts to determine their nature and to respond to complex calls related to specialized product lines or queues
  • Responds professionally to inquiries
  • Promotes, ensures, and provides customer service by demonstrating skills which are consistent with the organization's philosophy
  • Initiates contact with the appropriate company plan, medical group, and facility personnel to obtain information relevant to the concern or inquiry
  • Evaluates data to determine and implement the appropriate course of action to resolve the complaint, coordinate service recovery
  • Documents conversations with members according to procedure
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