Customer Service Representative - SCA

Acentra Health, LLC•UNAVAILABLE, UNAVAILABLE

9d•Remote

About The Position

Acentra Health is looking for a Customer Service Representative to join our growing team. The Call Center Representative is a front-line customer service role that assists state benefit system members and providers with questions regarding eligibility, benefits, claims, service authorizations, and program policies and procedures. This position responds to incoming calls, resolves customer inquiries, complaints, and requests, and adheres to established internal policies and procedures. Regular and reliable attendance is required, including the ability to work scheduled hours and meet job responsibilities in a timely manner. This position primarily involves working at a desk and using a computer for extended periods of time. This position is remote, but candidates must reside within driving distance of El Paso, TX or Tallahassee, FL as needs could change from remote to on-site in the future.

Requirements

High School Diploma or GED equivalent
Experience with computer applications, such as Microsoft Word and PowerPoint
Minimum of one year of call center experience
Must live within driving distance from El Paso, TX or Tallahassee, FL

Nice To Haves

Verbal and written communication skills, attention to detail, customer service skills
Ability to work independently and manage one's time
Ability to accurately document and record customer/client information

Responsibilities

Available to work scheduled work hours based on operational needs. A shift will be assigned to you between the hours of 8:00am-8:00pm Monday through Friday
Develop and maintain working knowledge of internal policies, procedures, and services.
Utilize automated systems to log and retrieve information; perform accurate and timely data entry.
Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times.
Respond to telephone inquiries in a prompt, accurate, and courteous manner.
Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients.
Perform verification of healthcare services to facilitate payment for received services.
Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data.
Serve as liaison between the internal and external partners.
Investigate and resolve or report provider problems.
Meet or exceed standards for call volume and service level per department guidelines.
Initiate cases by collecting and entering demographic, provider, and procedure information into the system.
Complete daily, monthly, and quarterly reports necessary for clinical team operations.
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.