SIHO Insurance Services
  • - Member Services
  • Columbus, IN, USA
  • Hourly
  • Full Time

This is a non-exempt position with primary responsibility for responding to members' questions, preparing reports, documenting complaints and clarifying benefits changes or exclusions. This position may also be responsible for reviewing, analyzing and approving routine health claims for payment.

Brief Description of Duties:

  • Respond to telephonic, written inquiries and emails from members, employers and providers
  • Assist members by solving issues relating to their health care coverage
  • Review claims that have processed to assist members and providers 
  • Utilize web based programs to assist members and providers
  • Determine if services are covered by the health plan by utilizing plan descriptions
  • Complete special projects (including research) as assigned by Member Services Manager
  • Understand and follow mandated (i.e., HIPAA, ERISA, Etc.) regulations promulgated by state or federal governmental agencies
  • Develop and maintain statistical data as required
  • Assist walk-in customers

Minimum Skills Requirement:

  • Must possess a passion for customer service
  • Must have excellent communications (oral and written) skills
  • General knowledge and understanding of health insurance
  • Post-secondary education or two years experience in customer service
  • Ability to work at a self-directed pace in a changing, multi-task environment
  • Professional appearance and presence
  • Commitment to support and maintain confidentiality in conformance to HIPAA guidelines
SIHO Insurance Services
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