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Customer Service Representative in Nashville, TN at KEPRO

Date Posted: 2/12/2018

Job Snapshot

Job Description



JOB TITLE:            CustomerService Representative

REPORTS TO:      Supervisor,Customer Service

FLSA STATUS:     Non-Exempt

Summary Description

Responsible for supporting the prior authorization processby answering incoming telephone calls, resolving customer questions, complaintsand requests adhering to internal policies and procedures and utilizing workingknowledge of the organization’s services to meet productivity and qualitystandards.  


  • Develops and maintains working knowledge ofinternal policies, procedures and services (both departmental andoperational). 
  • Utilizes automated systems to log and retrieveinformation. Performs accurate and timely data entry of electronic faxes.
  • Receives inquiries from customers or providersby telephone, email, fax, or mail and communicates response within requiredturnaround times. 
  • Responds to telephone inquiries and complaintsin a prompt, accurate, and courteous manner following standard operatingprocedures.
  • Interacts with hospitals, physicians,beneficiaries, or other program recipients. 
  • Investigates and resolves or reports customerproblems. Identifies and escalates difficult situations to the appropriateparty.
  • Meets or exceeds standards for call volume andservice level per department guidelines. 
  • Initiates files by collecting and enteringdemographic, provider and procedure information into the system. 
  • Serves as liaison between the Review Supervisorsand external providers.
  • Maintains logs and documents disposition ofincoming and outgoing calls.

The list of accountabilities is not intended to beall-inclusive and may be expanded to include other duties that management maydeem necessary from time to time.


  • High School diploma or equivalent.
  • Medical terminology course(s) helpful.


Knowledge of:

  • Medical terminology
  • Health insurance industry

Ability to:

  • Speak English fluently enough to be clearlyunderstood over the telephone.
  • Use phone system effectively.
  • Research and investigate.
  • Follow confidentiality policies and procedures.
  • Navigate and use electronic equipment andsystems easily and proficiently.
  • Multitask on a personal computer whileconducting telephone conversations.
  • Work in a fast-paced call center environment
  • Remain calm and courteous when handlingdifficult calls and request


  • Bilingual Spanish-English a plus.
  • Effective verbal and listening skills to providecourteous and professional customer service.
  • Effective PC skills including, electronic mail,intranet and industry standard applications.


  • 2+ year’s customer service/telephone experiencein a similar call center environment and/or industry.

Mental and PhysicalRequirements

The physical demands described here are representative ofthose that must be met by an employee to successfully perform the essentialfunctions of this job.  Reasonableaccommodations will be made as required by law in an attempt to enable anindividual with a disability to perform the essential functions of this job.  While performing the duties of this job, theemployee must have the ability to read and interpret data and complexinformation and function in a team environment. In addition, the employee is required to sit for extended periods oftime; key and/or control objects; occasionally lift and/or move objectsweighing up to 15 pounds; use a personal computer and communicate effectivelywith internal and external customers.