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.