Wellcove

Customer Support

• Provide customer service in a call center environment by receiving and responding to telephone inquiries
• Assist providers, agents, policyholders, and others with inquiries from third-party administrator clients, including Medicare Supplement and Life Policies
• Provide information regarding insurance questions, including verification of benefits and claims status
• Access and update software system data within company response standards
• Research company records to obtain requested information
• Perform routine transactions and retrieve results from an online terminal
• Maintain working knowledge of company products and services
• Comply with company regulations regarding privacy, confidentiality, and private health information
• Provide written and oral communication regarding inquiry status and resolution
• Initiate and complete Call Tracks, checklists, and supportive clerical responsibilities
• Work collaboratively while remaining accountable and able to work remotely and independently

Customer Service Representative, Contact Center

Claims Specialist

• Review and adjudicate long-term care claims and policy provisions for payment or denial
• Process payment or issue denial for invoices pertaining to long-term care claims
• Identify, analyze, and apply long-term care claim product features and applicable policy benefits
• Meet or exceed management-approved production and quality targets
• Respond accurately, timely, and professionally to external and internal correspondence regarding benefits, eligibility, claim payments, denials, and explanations of benefits
• Handle inbound claim calls
• Maintain working knowledge of company services and claims, administrative, and imaging software systems
• Operate in compliance with HIPAA, fraud, confidentiality, and private health information guidelines
• Perform other duties as assigned

Customer Service Representative, Contact Center

Claims Examiner