Careers

Customer Service Representative
Work from home opportunity!

Are you looking for a career with an established company who values its employees? Administrative Concepts, Inc. (ACI) is a fast-growing company that offers its employees meaningful work and a positive environment. Founded in 1997, ACI is a nationally licensed, full service, Third Party Administrator providing enrollment, fulfillment and claims processing services for various insurance lines in the medical claims industry.

This position is a work from home remote opportunity! Our office is located in Collegeville, PA. If you’re looking for a rewarding career, not just another job, then come join our team as a Customer Service Representative!

We’re looking for people who thrive on helping customers with a passion for service to join our growing call center. We offer employees an opportunity to develop their career because as they grow, we look to promote from within.

Responsibilities of the Customer Service Representative (Bilingual):

• Answer inbound calls and providing health insurance information to clients including bilingual members
• Responsible for maintaining a high level of professionalism with clients and working to establish a positive rapport with every caller
• Update customer information in the customer service database during and after each call
• Work with the management team to stay updated on product knowledge and be informed of any changes in company policies
• Handle 70-80 calls per day once fully up to speed (2-3 months)

Requirements of the Customer Service Representative (Bilingual):

• Bilingual Spanish
• Strong communication and interpersonal skills
• Basic computer skills (MS Office Preferred)
• Medical or health insurance background a plus
• Call center experience preferred but not required

We offer a comprehensive training program to prepare you for providing exceptional customer service.

Shifts & Benefits:

• Monday through Friday: 9am-5pm (primary shift), 10am-6pm or 12 pm-8 pm
• Bi-Lingual Spanish hourly incentive
• Background Check required for employment.
• PTO & Holiday Pay
• 401(k)
• Medical/Dental/Vision'

Job Type: Full-time

Pay: $31,200.00 - $37,440.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Paid training
• Vision insurance
• Work from home

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Spanish: 3 years (Required)

Work Location: Remote

GENERAL PURPOSE OF THE JOB: Review and process claims in accordance with training, guidelines, carrier directives, and policy provisions.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
1. Responsible for reviewing and maintaining a working knowledge of policy and state mandated insurance requirements.
2. Responsible to review and process claims for assigned accounts and back up as needed.
3. Prepare large claim files for review and send notifications in accordance with best practices for large claims.
4. Meet daily/weekly production goals established by management while maintaining processing and financial accuracy standards (95% minimum accuracy required).
5. Request refunds, voids, and no-pay adjustments as needed.
6. Respond to phone and email inquiries from clients, customers, and business partners (agents, brokers) when needed.
7. Provide customer service assistance in responding to benefit and claim questions.
8. Respond to questions and specific requests and provide complete information and documentation as needed.
9. Responsible to complete special projects.
10. Request subrogation and reimbursement letters from appropriate source.
11. Review and monitor the suspended claims list to ensure claims are processed within appropriate time limits.
12. Complete training rolled out by HR and claim management throughout the year.
13. Attend all individual, department and organizational meetings.
14. Uphold all company policies, procedures, and HIPAA guidelines
15. Adhere to the schedule they have selected, begin work on time.
16. Responsible to perform in accordance with all policies and provisions outlined in the ACI handbook.
17. Examiners must obtain and maintain individual adjuster licenses within the first twelve months of employment.
18. Other claim department duties as assigned by the manager.

DESIRABLE QUALIFICATIONS:
• Knowledge of industry and medical terminology and codes
• Understanding of the adjudication process
• Ability to prioritize and organize
• Strong verbal and written communication skills
• Strong data entry skills
• Experience with MS Office