Concierge Customer Service Representative

MedWatch • FL

75d • $16 - $18

About The Position

This is a critical position requiring excellent customer interaction skills. Individuals are expected to accurately service and satisfy customers by responding to customer inquiries. Concierge/Customer Service Representative needs to be versatile and equipped with a strong skill set to handle the complexity of the job. This is a remote position with no requirement to commute to an office.

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.

Nice To Haves

• Understanding of Self-Funded health benefits.
• Claim processing skills.
• Insurance verification or pre-certification.
• Provider office/facility billing department or financial area.

Responsibilities

• 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.

Benefits

• Equal Opportunity Employer, including disability/veterans.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 101-250 employees