For more than 60 years the SAG-AFTRA Health Plan and SAG-Producers Pension Plan (the Plans) have provided health and retirement benefits to thousands of entertainment professionals and their dependents across the globe. The Plans are currently undergoing a major transformation focused on evolving our operations toward a participant-inspired experience. This is an exciting opportunity for a skilled Participant/Client Service Representative to support our efforts.
Training is in the office 5x/week for the first 4 weeks. After training, this role is a hybrid role, requiring the employees to be in our Burbank office 1x (once)/week (or more based on business needs).
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The Participant Services Representative (PSD Rep) will be responsible for answering all of the incoming calls and inquiries for the Plan Office and is the primary source of general information as well as the Participant’s key to communication with the Plans. As the Participants’ first point of contact and often the primary source of information, the Service Representative contributes to the excellent customer service the Plan office strives to provide.Responsibilities include, but are not limited to:
- Responds to telephone inquiries regarding plan benefits, medical claim status including correspondence and payment, eligibility, general pension, coordination of benefits, earnings, premium information, and Plan website inquiries
- Documents all calls handled and consistently meeting established call quota
- Creates workflows to the claims department and other business units
- Requests applicable correspondence for providers and participants. Examples include but are not limited to: benefits, eligibility, pre-authorizations, and order of benefits
- Follows up on outbound calls and open CRM system contacts
- Processes requests for notice of eligibility, check tracers, forms or booklets
- Participates in QA coaching sessions
- Participates in training sessions and departmental meetings as required
- Performs duties assigned by management
- Responsible for successfully completing the required basic training
- Able to perform job functions with help from co-workers, specialists and managers
- Learning the activities/tasks associated with his/her role
- Works under direct supervision
- May rely on others for instruction, guidance, and direction
- Work is reviewed for technical accuracy and soundness
- Other duties as assigned.
Qualifications:
- High School Diploma or equivalent
- Minimum 1 year experience in a customer service role at a customer-centric organization required
- Minimum 1 year experience in the call center of a health insurance company highly preferred
- CPT, ICD9, HCPCS codes, and COB rules.
- Basic medical terminology is a big plus.
- Excellent written and oral communication skills
- Detail oriented with excellent organizational skills
- Ability to lead with empathy and compassion by building rapport quickly, being an attentive listener, having a thorough grasp of customer needs, excellent interpersonal skills, and seeing multiple perspectives
- Experience working with different software and programs with proven success in learning new technology
- Ability to manage all callers and situations in a professional, tactful, and courteous manner
- Ability to quickly acquire the knowledge of the Plan’s various retirement, health plans and other insurance plans
- Ability to quickly acquire the knowledge to use a variety of Plan system applications
- Ability to handle multiple interruptions and adjustments to priorities throughout the day
- Ability to maintain confidentiality
- Ability to maintain a QA percentage of 95%
- The ability to multi-task, including documenting the system during a call
- Ability to meet daily deadlines and call quota of 45, provided daily call volume is available
What we offer:
- Competitive Market Salary
- Comprehensive Medical, Dental, Vision insurance
- Generous Pension Plan
- Voluntary 401k participation
- Home Internet Stipend (monthly) & Office Equipment Reimbursement
- Access to discounted theme park, movie tickets, etc through GreatWorkPerks
- Continuous Education: LinkedIn Learning, Internal Learning Systems, etc.
For more information on Life at the Plans visit: LinkedIn: Life at the Plans
