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Job Summary:
The Customer Service Representative (“CSR”) role is responsible for providing support and assistance toÂ
Bankers Fidelity’s policyholders and providers by handling high-volume inbound calls, addressingÂ
inquiries, resolving issues efficiently and providing detailed information about benefits, claims, andÂ
policy provisions. Emphasis will be placed on achieving a one call resolution to ensure the highest levelÂ
of customer satisfaction. In this role, the CSR will be an ambassador of Bankers Fidelity’s mission to
deliver exceptional insurance solutions with accuracy, integrity, empathy, and professionalism. The CSRÂ
will uphold Bankers Fidelity’s core values of customer-centricity, accountability, and continuousÂ
improvement by providing reliable and compassionate service to Bankers Fidelity’s policyholders andÂ
other internal/external stakeholders. The CSR will demonstrate the ability to communicate effectivelyÂ
and resolve issues promptly to reinforce the trust and confidence policyholders place in Bankers Fidelity,Â
ensuring their experience aligns with the ongoing promise of quality service and support.
Key Responsibilities:
• Customer Service:
o Handle high volume inbound customer inquiries via phone, ensuring prompt and professionalÂ
service.
o Provide accurate and comprehensive information about insurance policies, benefits, andÂ
coverage.
o Resolve customer complaints and issues within a single call whenever possible, aiming for oneÂ
call resolution.
• Claim Adjudication:
o Demonstrate a thorough understanding of healthcare and other applicable insurance claimÂ
adjudication processes to accurately address and resolve policyholder inquiries and issues.
o Assist providers with claim(s) processing, including guidance for claim submission, clarifyingÂ
reimbursement procedures, and ensuring compliance with Medicare and industry guidelines.
o Educate customers about the claim adjudication process and policy details.
Disclaimer: This job description is not all-inclusive, and additional duties may be assigned. Bankers Fidelity provides reasonable accommodations for individualsÂ
with disabilities as required by law. As an Equal Opportunity Employer, we consider all qualified applicants without regard to race, color, religion, sex, sexualÂ
orientation, gender identity, national origin, disability, or veteran status. Employment is at-will and may be terminated at any time, with or without cause orÂ
notice.
• Daily Operations:
o Maintain accurate and up-to-date records of customer interactions and transactions.
o Collaborate with other departments, including Medicare Supplement Claims Examiners,Â
Ancillary Examiners, and other stakeholders to ensure seamless service delivery.
o Identify and escalate complex issues to the appropriate department for further resolution.
o Demonstrate Bankers Fidelity’s commitment to integrity, empathy, and professionalism in everyÂ
customer interaction.
• Training and Development:
o Stay informed about industry trends, CMS guidelines, and company policies related to MedicareÂ
Supplement and all other applicable insurance.
Qualifications:
• Experience:
o Strong knowledge of Medicare Supplement and other applicable insurance policies
o Healthcare claim adjudication processesÂ
o Experience handling high-volume inbound calls with a focus on one call resolution.
• Knowledge:
o Excellent communication and interpersonal skills.
o Proficiency in using customer service software, databases, and tools.
o Strong problem-solving skills and attention to detail.
o Ability to work independently and as part of a team.
• Education:Â
o High school diploma or equivalent
Skills:
• Customer Service Excellence: Ability to provide exceptional customer service by understandingÂ
policyholder needs, addressing concerns promptly, and ensuring a positive customerÂ
experience.
• Communication: Strong verbal and written communication skills to convey information clearlyÂ
and effectively to policyholders and providers.
• Empathy and Patience: Demonstrated ability to empathize with policyholders and providers,Â
showing patience and understanding in all interactions.
• Problem-Solving: Aptitude for identifying issues, evaluating options, and implementing effectiveÂ
solutions in a timely manner.
• Attention to Detail: Keen attention to detail to ensure accuracy in handling customerÂ
information, claim(s) processing and maintaining records.
• Industry Knowledge: Up-to-date knowledge of Medicare Supplement insurance, Centers forÂ
Medicare, and Medicaid Services (CMS) guidelines and claim adjudication processes.
• Technical Proficiency: Familiar with customer service software, databases, and other relevantÂ
tools to manage customer interactions and records.
• Time Management: Ability to handle multiple tasks efficiently, prioritize work, and manage timeÂ
efficiently in a high-volume environment.
Disclaimer: This job description is not all-inclusive, and additional duties may be assigned. Bankers Fidelity provides reasonable accommodations for individualsÂ
with disabilities as required by law. As an Equal Opportunity Employer, we consider all qualified applicants without regard to race, color, religion, sex, sexualÂ
orientation, gender identity, national origin, disability, or veteran status. Employment is at-will and may be terminated at any time, with or without cause orÂ
notice.
• Adaptability: Flexibility to adapt to changing industry trends, company policies and policyholderÂ
needs.
• Team Collaboration: Capability to work collaboratively with colleagues and other departmentsÂ
to achieve common goals and ensure seamless service delivery.
Work Environment / Physical Requirements:
The work environment is a standard office setting with typical office equipment. This role involvesÂ
professional collaboration with colleagues and clients. Responsibilities may involve extended periods ofÂ
sitting, occasional walking between departments or meeting rooms, and periodic standing, reaching,Â
stooping, and lifting office items weighing up to 25 pounds
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