Customer Service Rep IV

Company: Sentara Health
Location: Virginia Beach
Posted on: March 6, 2025

Job Description:

City/State
Virginia Beach, VA

Overview

Work Shift
First (Days) (United States of America)

Responsible for all areas of customer service as it pertains to the acquisition and/or retention of members within the health plan or customer access as it relates to patient scheduling and referral within the Access Center. Performs routine & complex servicing of operational issues for providers, members, benefit administrators (Bas), brokers, or provider practices. Serves as the subject matter expert in customer operations for benefit administration, claims, pharmacy issues, group set up, enrollment, billing, broker commission or access and referral issues if within the Access Center. Responsible for root cause analysis and trending of repeat service issues as they pertain to strategic initiatives with particular focus on easy to do business with (ETDBW) initiatives. Works with leadership to implement processes that support ETDBW initiatives.

Acts as the team leader in support of Customer Service Rep teams.

5 years' experience in customer service, health plan claims, marketing, pharmacy tech, OR sales is required.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

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Job Summary

Responsible for all areas of customer service as it pertains to the acquisition and/or retention of members within the health plan or customer access as it relates to patient scheduling and referral within the Access Center. Performs routine & complex servicing of operational issues for providers, members, benefit administrators (Bas), brokers, or provider practices. Serves as the subject matter expert in customer operations for benefit administration, claims, pharmacy issues, group set up, enrollment, billing, broker commission or access and referral issues if within the Access Center. Responsible for root cause analysis and trending of repeat service issues as they pertain to strategic initiatives with particular focus on easy to do business with (ETDBW) initiatives. Works with leadership to implement processes that support ETDBW initiatives.

Acts as the team leader in support of Customer Service Rep teams.

5 years' experience in customer service, health plan claims, marketing, pharmacy tech, OR sales is required.

Qualifications:

HS - High School Grad or Equivalent (Required)

Customer Service, Health Plan Claims Disbursmnts, Marketing, Pharmacy Technician, Sales

Skills

Microsoft Access, Microsoft Excel, Microsoft Word

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission "to improve health every day," this is a tobacco-free environment. Associated topics: call center associate, customer care representative, customer service, intern, rep, representante de servicio al cliente, service, technical support, telephone service representative, tsr

Keywords: Sentara Health, Virginia Beach , Customer Service Rep IV, Sales , Virginia Beach, Virginia