Customer Service Representative
Job Title: Customer Service Representative
Job Description:
- Primary job function is answering inbound calls
- Handle provider inquiries regarding eligibility, benefits and claims for insurance
- Various off phone projects
- Checking provider voice mails
- Responding to email inquiries and secured portal messages
- Investigating claim issues and following up with billing offices
- Requesting EOBs
- Call Center staff will be trained on both MA & NH plans
Daily 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 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
Hours for this Position:
- Monday - Friday, 8:30am - 5:00pm
Compensation:
- $15 -16/hour (Negotiated based on experience)
- HS Diploma
- Healthcare experience, required
- Experience with providers, medical billing, or claims
- 2+ years of customer service experience
- Commercial health insurance experience, preferred
- Must pass all aspects of background check to be considered for permanent position
Advantages of this Opportunity:
- Competitive salary, negotiable based on relevant experience
- Benefits offered: Medical, Dental, and Vision
- Fun and positive work environment
Interested in being considered?
If you are interested in applying to this position, please contact Suheyn Zambrano at (407) 478-0332 ext. 112 and click the Green I’m Interested Button to email your resume.