CSR/ Member Service Rep
Position Purpose:
• Receive and respond to telephone inquiries from members or providers regarding eligibility, benefits and authorization of services. Educate callers on behavioral health program and procedures.
Position Responsibilities:
• Receive and respond to all telephone inquiries from members or providers
• Research and provide information regarding member's eligibility, benefits, referrals and authorizations
• Provide members with information on the Provider Network and how to contact and access providers
• Educate providers on prior authorization requirements, how to access services and other routine, non-clinical issues
• Educate providers on process of submitting outpatient treatment requests for outpatient therapy
• Initiate or fax necessary forms to providers for outpatient therapy services
• Coordinate with Provider Relations regarding contracting and/or credentialing status
• Document all members' issues and resolution in the computer systems
• Provide backup support to Data Entry team as necessary
• Must have a High school Diploma or GED equivalent, from an accredited school
• Must have good communication skills
• Must have Health Care Experience
• Must be computer proficient: Microsoft Office, Word and Excel, Typing skills 30 WPM or above.
Are you an experienced Registered Nurse with Corporate training experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!
Interested?
Please click APPLY for immediate consideration.