Concierge Customer Service Representative – Remote Opportunity at careerzynith

Remote Full-time
**Job Summary:**

Join careerzynith, a leading healthcare solutions provider, as a Concierge Customer Service Representative. In this critical role, you will be the face of our organization, providing exceptional customer service to our members and providers. As a versatile and skilled professional, you will navigate complex situations with tact and diplomacy, ensuring that our customers receive the highest level of care and satisfaction. If you possess excellent communication skills, a strong work ethic, and a passion for delivering exceptional customer experiences, we encourage you to apply for this exciting opportunity.

**About careerzynith:**

careerzynith is a community of passionate, driven individuals who thrive on innovation and collaboration. For over 35 years, we have partnered with clients to develop innovative and effective solutions to address their needs. By mitigating risk within the plan population and focusing on quality care and improved outcomes, careerzynith reduces healthcare expenditures for the plan and plan member. We offer competitive compensation and a comprehensive benefits package, including Paid Time Off, Medical, Dental, Vision, Short and Long-Term Disability, Life Insurance, AD&D, 401k with match, critical illness coverage, and discount programs.

**Key Responsibilities:**

As a Concierge Customer Service Representative, you will be responsible for:

* Responding to telephone and email inquiries received from members and providers within defined service standards
* Negotiating with providers to gain acceptance for plans without network agreements and/or out of network providers
* Assisting members with benefits and healthcare questions
* Documenting all calls received in system-based call log
* Providing exceptional customer service and resolving issues in a timely and professional manner
* Collaborating with internal teams to ensure seamless communication and resolution of customer inquiries
* Staying up-to-date with industry developments and regulatory changes to provide accurate and informed responses to customer inquiries

**Requirements and Qualifications:**

To be successful in this role, you will need:

* A minimum of a High School Diploma or GED, with 2 years of college or higher education preferred
* One year of customer service or call center experience in a healthcare-related role
* Medical intake or Third-Party Administrator (TPA) experience is preferred
* Bilingual English-Spanish is a plus
* Strong customer relations, interpersonal, and communication skills
* Ability to handle confidential and sensitive information with discretion and tact
* Proficient with Microsoft applications and strong computer skills
* 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
* Independent judgment in decision-making and problem-solving
* Ability to multitask and anticipate potential needs/problems
* Strong analytical and research skills
* Medical Terminology
* Strong attention to detail
* Understanding of Self-Funded health benefits is a plus
* Claim processing skills are a plus
* Insurance verification or precertification is a plus
* Provider office/facility billing department or financial area experience is a plus

**Work Environment and Physical Demands:**

This position is in a typical office/home office environment, requiring prolonged sitting in front of a computer. You will need hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including standard computer and phone equipment.

**Compensation and Benefits:**

careerzynith offers a competitive compensation package, including:

* Pay range: $16.00 to $18.00 per hour
* Comprehensive benefits package, including Paid Time Off, Medical, Dental, Vision, Short and Long-Term Disability, Life Insurance, AD&D, 401k with match, critical illness coverage, and discount programs

**Equal Opportunity Employer:**

careerzynith is an Equal Opportunity Employer, including disability/veterans. We are committed to creating an inclusive and diverse work environment that values and respects the contributions of all employees.

**How to Apply:**

If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we will review your qualifications and experience.

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