Telephonic Intake Representative

FullscopeRMS helps health plans and insurance carriers grow their businesses with our turn-key solutions for group life & disability, absence management, supplement health and medical stop-loss products.

We are a subsidiary of Sun Life, a leading provider of group insurance benefits in the U.S.. FullscopeRMS also provides group life and disability plans to our clients through the third-party administrator Disability Reinsurance Management Services, Inc., often referred to as DRMS.

Job Description:

SUMMARY: Under direct supervision, the Telephonic Intake Representative is responsible for handling inbound calls from employees, employers and leave management vendor reporting a disability claim.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Promptly takes inbound calls from employees, employers and Leave Management vendor including new claim Intake scripts reporting a disability and or absence claim in a professional manner, adhering to service standards
• Accurately identifies employee eligibility information, obtains required information and posts new claims in the administrative system
• Follows up with claimants, employers and physicians to obtain missing claim information
• Answers questions related to claim process/workflow, explains basic contractual questions and responds to various claim inquiries
• Works collaboratively with other staff members to facilitate the accurate posting of claims
• Develops and maintains online claim data, including letters
• Ensures complete and accurate claim file documentation
• Assists in maintaining business process documentation, as new procedures are developed and best practices are identified

ADDITIONAL RESPONSIBILITIES:

• Assist with administrative requests
• Assist with department projects as needed
• Other duties and responsibilities as assigned

QUALIFICATIONS:

• Minimum 1 year work experience required, 1 year customer service experience preferred
• High school diploma or equivalent required
• Excellent communication skills, both written and verbal, with a pleasant and professional communication style

• Strong interpersonal skills and customer service focus
• Ability to initiate and prioritize regular work duties and small projects,
• Ability to multitask, be detail oriented, organized, and exercise good time management skills
• Must possess basic contract knowledge and have the ability to interpret and communicate various provisions
• Ability to work independently and as part of a team
• Good computer skills; proficient in PC environment, with basic skills in Excel, Word and email systems
• Ability to use office equipment including fax machine, photocopier, and printer
• Ability to work professionally and effectively with co-workers, clients, claimants, vendors and others with whom DRMS does business

Sun Life Financial (U.S.) Services Company, Inc. is a federal contractor subject to Executive Order 11246, Section 4212 of the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended, and Section 503 of the Rehabilitation Act of 1973, as amended. As such the company is committed to taking positive steps to implement the employment-related aspects of the company’s equal employment opportunity policy. It is the company’s policy to take affirmative action to employ, advance in employment, and otherwise treat qualified minorities, females, protected veterans, and individuals with disabilities without regard to their race/ethnicity, sex, veteran status, or disability.

Pursuant to 41 CFR §§ 60-300.44(f)(1)(ii) and 741.44(f)(1)(ii), we hereby notify you of our company policy related to our affirmative action efforts and request appropriate action on your part.

Job Category:

Customer Service / Operations

Posting End Date: