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Customer Service Representative – Wixom / Troy

Job Title: CSR Department: Customer Service
Location: Wixom / Troy Classification: Non-exempt
Reports to: Team Support/Sr. Team Leader Created on: 01/10/2020



Representatives will require the ability to multi-task and utilize multiple computer applications to access and enter data in member accounts.  Representatives will also be required to conduct themselves in a HIPAA compliant and ethical manner.  Duties include, but are not limited to: Incoming and outgoing calls, new account creation, insurance verification, document processing, order set up and management.  Representatives will be required to communicate professionally with members, caregivers, guardians, medical professionals, and co-workers.

Essential Functions:

  • Handle a variety incoming and outgoing calls using the (both through Shore-Tel and from the answering service) regarding new and/or existing members/caregivers needs
  • Ability to utilize multitask using multiple computer applications/programs
  • Creation of new member accounts
  • Review/Update all demographic and personal health information in the member’s account, including but not limited to the following: address – both mailing and shipping if different, phone number(s), e-mail address(es), physician information, caregiver(s), etc.
  • Access and enter data in existing patient accounts following HIPAA guidelines.
  • Insurance verification following established verification processes.
  • Speaks with members, caregivers, doctors and other outside providers to regarding member account and product needs.
  • Document all interactions in patient medical records for proper record keeping (account notes).
  • Documentation creation and follow up to ensure necessary documentation on file to ship supplies per Insurance guidelines (Advanced beneficiary Notification, Certificate of Medical necessity, Prescriptions, Letter of Medical Necessity, etc).
  • Fax and review incoming documentation as needed
  • Communication with patient or caregiver to keep up to date on account statuses
  • Liaise with Team Support or Team Lead as needed for all important matters that require supervisor approval or intervention.
  • Utilize the Customer Service Wiki daily for processes, procedure, insurance guidelines, product and company information.
  • Build proficiency and strong knowledge base on all product lines serviced.
  • Makes suggestions for process improvements and assists with projects as able.
  • Submit reports and productivity tracking to leaders as requested.
  • Track attendance and submit all applicable requests using the Attendance on Demand system.
  • Follow established building entry, compliance and system security policies.
  • Adhere to all Nondiscrimination and Accessibility guidelines.
  • Knowledge of all aspects of the company including cash sales, department structure, accessibility tools, websites, etc.


Key Competencies:

  • Accountability
  • Action Oriented
  • Communicates Effectively
  • Customer Focus
  • Nimble Learning
  • Being Resilient
  • Resourcefulness
  • Self-Development
  • Instills Trust


Supervisory Responsibilities:

The Customer Service Representative has no supervisory responsibilities.


Work Environment:

This job is performed in an office setting.  This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.


Physical Demands:

While performing the duties of this job, the employee is regularly required to speak, hear and see.  The employee is frequently required to stand, walk, use hands to finger, handle or feel and reach with hands and arms.


Position Type:

This is a full-time position, with a regular 40-hour work schedule.  At times, overtime may be required.



This position does not require travel.


Preferred Education and Experience:

  • 2+ years of experience in a fast-paced customer service role requiring the ability to handle multiple tasks at various stages of completion.
  • Previous experience requiring clear and calm communication by phone.
  • Previous experience requiring the ability to effectively use computer system and maintain good records.


Required Education and Experience:

  • High school diploma or GED


Other Duties:

All other duties as assigned by management.  Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are request of the employee for this job.  Duties, responsibilities and activities may change at any time with or without notice.