Clinical Service Rep

Cooper University Hospital•Camden, NJ

7d•$20 - $31

About The Position

Responsible for communication between all customers via telephone. Customers include employees, members, physicians, referral sources, and providers. The communication includes, benefit coverage, medical services, appeals and grievances, provider access and availability, claims investigation. The position utilizes computer terminal to manage and obtain essential information. Researches inquiries and demonstrates a strong ability to resolve issues according to the Plan document and policies and procedures. Refers unsolved inquiries and corrections to the appropriate analyst for resolution. Achieves maximum time effectiveness and customer service by answering all incoming phone calls within 3 rings. Provides clerical and telephone support for Case Management program. Maintains provider file compliance according to directive. Performs duties as assigned by Supervisor within the scope of knowledge and skill.

Requirements

Previous customer service experience
High School Diploma or Equivalent required

Nice To Haves

Medical or health insurance background preferred

Responsibilities

communication between all customers via telephone
benefit coverage
medical services
appeals and grievances
provider access and availability
claims investigation
utilizes computer terminal to manage and obtain essential information
researches inquiries and demonstrates a strong ability to resolve issues according to the Plan document and policies and procedures
refers unsolved inquiries and corrections to the appropriate analyst for resolution
achieves maximum time effectiveness and customer service by answering all incoming phone calls within 3 rings
provides clerical and telephone support for Case Management program
maintains provider file compliance according to directive
performs duties as assigned by Supervisor within the scope of knowledge and skill