Customer Service Representative (Bilingual - Remote - SCA)

Acentra Health, LLC

105d • $17

About The Position

Acentra Health is looking for a Customer Service Representative (Bilingual) to join our growing team. The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization’s services to meet productivity and quality standards. This position is remote. Shifts will be assigned within the operating hours of 8:45 a.m. to 8:15 p.m. ET, Monday through Friday, and 9:45 a.m. to 7:15 p.m. ET on weekends and holidays.

Requirements

• Requires a High School diploma or equivalent
• Requires a minimum of two years of customer service experience
• Bilingual (Spanish/English)

Nice To Haves

• Must have ability to research and resolve issues related to Medicaid program and service eligibility
• PC proficiency to include Microsoft Office Suite
• Knowledge of medical terminology
• Knowledge of the health insurance industry
• Effective verbal and listening skills
• Knowledge of CPT and HCPCS codes preferred
• Bilingual Spanish-English a plus

Responsibilities

• Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes
• Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
• Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
• Interacts with hospitals, physicians, beneficiaries, or other program recipients
• Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party
• Meets or exceeds standards for call volume and service level per department guidelines
• Initiates files by collecting and entering demographic, provider, and procedure information into the system
• Serves as liaison between the Review Supervisors and external providers
• Maintains logs and documents disposition of incoming and outgoing calls
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Benefits

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED