Population Health Management - The RIGHT CARE at the RIGHT TIME in the RIGHT PLACE at the RIGHT COST

Concierge Customer Service Representative

Customer SupportCustomer SupportFull TimeRemoteTeam 201-500Since 1988H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

34 days ago

Salary

$16 - $18 / hour

High School1 yr expEnglishSpanish

Job Description

• Respond to telephone and email inquiries received from members and provider within defined service standards. • Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers. • Assist members with benefits and healthcare questions. • Document all calls received in system-based call log. • The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice.

Job Requirements

Minimum HS Diploma/GED, 2 years college or higher education preferred.
One year Customer Service / Call Center experience in a health care related role.
Medical Intake or Third-Party Administrator (TPA) experience preferred.
Bilingual English-Spanish a plus.
Patience and ability to handle difficult situations tactfully and diplomatically.
Strong customer relations, interpersonal skills.
Strong appreciation and ability to handle confidential & sensitive information.
Proficient with Microsoft applications, strong computer skills and computer navigation.
Excellent data entry and typing skills.
Knowledge of provider organizations and networks.
Knowledge and understanding of CMS Medicare reimbursement rates.
Ability to effectively negotiate rate structures.
Takes initiative to resolve situations and to accomplish projects actions and tasks.
Excellent verbal and written communication skills.
Independent judgment in decision making and problem solving.
Ability to multi-task and anticipate potential needs/problems.
Ability to build relationships with internal and external customers.
Medical Terminology
Strong attention to detail.
Understanding of Self-Funded health benefits a plus.
Claim processing skills a plus.
Insurance verification or pre-certification a plus.
Provider office/facility billing department or financial area.
Strong analytical and research skills
Bilingual English-Spanish a plus.