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Customer Service Representative


Trustmark Health Benefits is seeking Work from Home Customer Service Representatives in Mountain Time zone.



Trustmark Health Benefits is a passionate and purpose-driven team of colleagues who contribute to Trustmark’s mission of helping people increase wellbeing through better health and greater financial security. At Trustmark, you’ll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves.



For more than four decades, Trustmark Health Benefits has crafted integrated, flexible, and tailored employer health plan designs that seamlessly meet specific business needs and delight members. Each of our offices around the country is managed locally, by industry veterans who understand the dynamics of the markets they serve. Our responsive and empathetic service teams provide the highest level of support for employers and members. Our local expertise and service represents our national strength. We are an independently operated subsidiary of Trustmark Mutual Holding Company.



Customer Service Representatives are responsible for providing information on a variety of topics such as benefits, eligibility, claim status, claim disposition and so on. If you have customer service experience and enjoy providing service by accurately and respectfully responding to telephone, written, and electronic inquiries from members, providers and clients, let us know by applying today.



Requirements:

  • You are responsible for securing reliable, high speed internet access and for the expenses related to this access. Company will provide the required hardware and software.
  • Ability to Safeguard Protected Health Information (PHI), work must be performed in a home office area where access is limited, preferably in a room that can be secured and no one else is to be in the home office area while you are working.
  • High School Diploma or GED equivalent
  • Prior experience in a fast-paced call center
  • Experience in at least 1 of the following areas:
    • Self-Funded Insurance/Benefits and/or TPA experience
    • knowledge of medical procedure and diagnosis coding
    • Knowledge of medical terminology
    • Familiarity with Summary Plan Documents (SPDs)/Insurance Booklets or other benefit descriptive tools
  • Excellent verbal communication skills
  • Effective written communication skills
  • Ability to work effectively with team members, employees/members, providers, and clients
  • Flexible; open to continued process improvement
  • Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word/Microsoft Teams
  • Work from home experience preferred
  • Bilingual preferred


Key Accountabilities:

  • Respond to telephone, written and electronic inquiries from employees/members, providers, clients and other interested parties using system notes, plan documents and booklets, benefit reference documents, Claim Reference Manuals and claims-related memoranda.
  • Treat all inquiries professionally and respectfully following Trustmark Health Benefits guidelines.
  • Appropriately refer or escalate calls based on customer service procedures and guidelines.
  • Research inquiries and respond appropriately.
  • Appropriately refer unresolved inquiries or inquiries requiring further action to the appropriate individual, e.g. Analyst, Corrections, Senior, Supervisor/Manager.
  • Follow-up regularly on outstanding issues to ensure timely resolution and client satisfaction.
  • Thoroughly and accurately document all inquiries using PowerSTEPP and Family Files following Trustmark Health Benefits guidelines
  • Communicate via telephone, email, electronic messaging, fax, or written letter with employees/members, providers of service, clients and/or other insurance carriers to ensure proper claim processing and issue resolution.
  • Initiate outgoing calls or other service projects as assigned
  • Other duties as needed/assigned


All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, or disability



Required Skills



Required Experience
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