Job description

We are offering a $1,000 sign-on bonus for the training class beginning on 07/25/2022!

Summary of Job: To provide telephonic customer service to members, providers and facilities.

Responsibilities:

· Receives and responds to telephone calls and correspondence from members, regarding billing, benefits, coverage, payment, coding, and health services policies and procedures.

· Maintains telephone log documenting number, content and type of calls received.

· Explains medical pre-authorization requirements and disposition of pre-authorization requests, as necessary.

· Researches and analyzes recurring billing and eligibility problems/complaints to determine root causes and trends.

· Collaborates with Management to identify areas of member/participant dissatisfaction and trends concerning membership or benefits.

· Researches and analyzes recurring member problems/complaints to determine root causes and trends; recommends solutions and/or resolutions.

· Provides instruction to members for submitting out-of-plan medical claims.

· Acts as customer advocate in providing assistance to resolve callers' issues and problems.

· May provide instruction to members for obtaining prior approval on benefits that have certain restrictions.

· Investigates requests for claims adjustments by callers and collaborates with Claims teams to ensure claims adjustments have been made. Follows thru w/callers by communicating when/if adjustments cannot be made.

· Performs other related projects and duties as assigned.

Qualifications:

· Post High School education/training or equivalent combination of education and experience.

· At least 2 years of previous customer service experience in a medical office, sales/service or billing environment required; telephonic customer service experience preferred.

· Knowledge of Medicare Regulations/Product, ICD-9 and ICD-10 diagnosis, CPT-4, UB82 revenue codes, UB92 revenue coding and procedural coding desired.

· Excellent oral and written communication skills and interpersonal skills required.

· Previous system user experience in a highly automated environment required. Strong personal computer skills.

· Demonstrated analytical skills desirable.

· Excellent telephone manner: ability to handle high volume of calls efficiently and courteously.

· Ability to perform in office environment with extended periods of sitting, using telephone, viewing computer screens, standing, reaching, lifting files, binders, computer reports.

Essential Job Requirements:

· Primarily sedentary

· Must be able to use standard office equipment

Job Type: Full-time

Pay: $19.23 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• Weekend availability

Supplemental pay types:

• Signing bonus

Ability to commute/relocate:

• Farmington, CT 06032: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Required)

Experience:

• Call center: 1 year (Preferred)

Work Location: One location

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