REMOTE CUSTOMER SERVICE REP $18.00- $19.00 PER HR
Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
Provides triage and management of calls ensuring that established call performance targets are consistently achieved.
Provides feedback to leadership regarding training needs
Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
Participates in special projects and performs other duties as assigned.
Has strong organizational skills
Work Experience:
Minimum of two years of experience in a customer service role Required
Excellent oral and written communication skills Required
Advanced personal computer skills, including Word, Excel or Access Required
Utilization Management experience Preferred
Health care background Preferred
EMAIL RESUMES TO: [email protected]
An Equal Employment Opportunity Employer