Senior Client Services Representative

Reliant

5d•$50,000 - $65,000

About The Position

Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client’s needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative. As a Senior Client Services Representative, you are responsible for assisting assigned clients with various requests. Perform as liaison between Reliant and its clients by providing support to all Customer Service and Negotiator team members to assist in achieving timing and savings goals. Deliver quality Customer Service via telephone and written correspondence, using established guidelines to ensure issues are satisfactorily resolved.

Requirements

4 – 6 years of insurance claims or customer service experience.
Ability to analyze patient information and determine appropriate course of action.
Experience understanding Reliant critical behaviors and compliance requirements.
Broad healthcare policy and payment understanding.
Experience with claims workflow tools or systems.

Responsibilities

Research and resolve issues for negotiators, providers, and payors. Communicate via telephone and written correspondence. Utilize the Action Request Process to document and manage requests.
Respond to client, negotiator or management requests in a timely manner. Follow department policies and procedures. Meet or exceed production, accuracy and turnaround time requirements.
Review and update claim pends and exceptions, as assigned.
Answer incoming calls, assist callers with questions and transfer calls to the proper individual when needed. Document calls as appropriate.
Perform administrative duties
Perform other job-related duties or special projects as required.
Monitor inventory, queues and workload. Address concerns as appropriate, facilitate resolution of large dollar and high priority claims.
Provide initial and on-going training to team members. Provide feedback to team members and/or management. Assist others in organizing, setting priorities, and monitoring workflow.
Participate and support client implementations. Create and maintain reference materials and complete other assigned tasks. Handle special requests made by clients or account managers.
Serve as backup support for the department leader, as needed.