Experienced Customer Service Representative – Medical Claims Navigation
At careerzynith, we're dedicated to providing exceptional patient care and delivering top-notch medical equipment and respiratory services to our community. With over 70 years of experience, we've established ourselves as a trusted and reputable provider in the durable medical equipment and respiratory industry. Our commitment to excellence has earned us numerous prestigious awards, including the NorthCoast 99 Award as a Top Workplace to work and the National HME Excellence Award for Best Home Medical Equipment company in the US.
As a family-owned and operated business, we prioritize our employees' growth and well-being. We're proud to offer a comprehensive benefits package, competitive pay, and opportunities for advancement. If you're a motivated and detail-oriented individual looking to make a meaningful impact in the medical industry, we encourage you to apply for our Customer Service Representative – Medical Claims Navigation (CMN) role.
**About the Role**
As a CMN representative, you'll play a vital part in ensuring the timely and accurate processing of medical claims. Your primary responsibilities will include reviewing initial prescriptions, completing daily follow-up processes, and managing the CMN renewal process. You'll also be responsible for handling phone calls related to CMNs and collaborating with the Director of Revenue to improve processes and drive success.
**Key Responsibilities and Duties**
* Review initial prescriptions for qualifying elements and ensure timely release of claims
* Complete daily follow-up processes on all CMNs assigned within the WIP states/RC worklist
* Review possible renewal CMNs within the CMN review worklist and manage the CMN renewal process
* Obtain all necessary documentation and handle outstanding held revenue related to CMNs for assigned branches
* Manage phone calls related to CMNs and provide exceptional customer service
* Perform other duties as assigned by the Director of Revenue
**Essential Qualifications**
* High school diploma or equivalent
* Proven ability to multi-task in a fast-paced environment
* Detail-oriented and team-oriented with effective communication (verbal and written) and organizational skills
* Proven computer proficiency, including the use of multiple applications simultaneously
* Knowledge of the HME/DME industry is preferred
**Preferred Qualifications**
* Previous experience in a customer service or medical claims navigation role
* Familiarity with medical terminology and coding
* Strong analytical and problem-solving skills
**Skills and Competencies Required for Success**
* Excellent communication and interpersonal skills
* Ability to work in a team environment and collaborate with colleagues
* Strong organizational and time management skills
* Proficiency in Microsoft Office and other software applications
* Ability to adapt to changing priorities and deadlines
* Strong attention to detail and accuracy
**Career Growth Opportunities and Learning Benefits**
At careerzynith, we're committed to investing in our employees' growth and development. As a CMN representative, you'll have opportunities to:
* Develop your skills and knowledge in medical claims navigation and customer service
* Collaborate with experienced professionals in the industry
* Participate in training and development programs to enhance your performance
* Take on new challenges and responsibilities as you grow in your role
**Work Environment and Company Culture**
Our remote work environment offers flexibility and autonomy, allowing you to work from the comfort of your own home. Our company culture values:
* Collaboration and teamwork
* Open communication and transparency
* Continuous learning and growth
* Employee well-being and work-life balance
**Compensation, Perks, and Benefits**
We offer a competitive salary, starting at $16.50, and a comprehensive benefits package, including:
* Medical, dental, and vision insurance
* HSA account with company contribution
* Pet insurance
* Company-provided life and AD&D insurance
* Short-term and long-term disability
* Tuition reimbursement program
* Employee assistance program (EAP)
* Employee referral bonus program
* 401(k) with matching program and Roth IRA
* Company discounts
* PayActive/on-demand pay
* Paid vacation, sick days, you days, and holidays
**Conclusion**
If you're a motivated and detail-oriented individual looking to make a meaningful impact in the medical industry, we encourage you to apply for our Customer Service Representative – Medical Claims Navigation role. Join our team at careerzynith and take the first step towards a rewarding new career. Apply now and seize this opportunity to make a significant impact!
Apply for this job
As a family-owned and operated business, we prioritize our employees' growth and well-being. We're proud to offer a comprehensive benefits package, competitive pay, and opportunities for advancement. If you're a motivated and detail-oriented individual looking to make a meaningful impact in the medical industry, we encourage you to apply for our Customer Service Representative – Medical Claims Navigation (CMN) role.
**About the Role**
As a CMN representative, you'll play a vital part in ensuring the timely and accurate processing of medical claims. Your primary responsibilities will include reviewing initial prescriptions, completing daily follow-up processes, and managing the CMN renewal process. You'll also be responsible for handling phone calls related to CMNs and collaborating with the Director of Revenue to improve processes and drive success.
**Key Responsibilities and Duties**
* Review initial prescriptions for qualifying elements and ensure timely release of claims
* Complete daily follow-up processes on all CMNs assigned within the WIP states/RC worklist
* Review possible renewal CMNs within the CMN review worklist and manage the CMN renewal process
* Obtain all necessary documentation and handle outstanding held revenue related to CMNs for assigned branches
* Manage phone calls related to CMNs and provide exceptional customer service
* Perform other duties as assigned by the Director of Revenue
**Essential Qualifications**
* High school diploma or equivalent
* Proven ability to multi-task in a fast-paced environment
* Detail-oriented and team-oriented with effective communication (verbal and written) and organizational skills
* Proven computer proficiency, including the use of multiple applications simultaneously
* Knowledge of the HME/DME industry is preferred
**Preferred Qualifications**
* Previous experience in a customer service or medical claims navigation role
* Familiarity with medical terminology and coding
* Strong analytical and problem-solving skills
**Skills and Competencies Required for Success**
* Excellent communication and interpersonal skills
* Ability to work in a team environment and collaborate with colleagues
* Strong organizational and time management skills
* Proficiency in Microsoft Office and other software applications
* Ability to adapt to changing priorities and deadlines
* Strong attention to detail and accuracy
**Career Growth Opportunities and Learning Benefits**
At careerzynith, we're committed to investing in our employees' growth and development. As a CMN representative, you'll have opportunities to:
* Develop your skills and knowledge in medical claims navigation and customer service
* Collaborate with experienced professionals in the industry
* Participate in training and development programs to enhance your performance
* Take on new challenges and responsibilities as you grow in your role
**Work Environment and Company Culture**
Our remote work environment offers flexibility and autonomy, allowing you to work from the comfort of your own home. Our company culture values:
* Collaboration and teamwork
* Open communication and transparency
* Continuous learning and growth
* Employee well-being and work-life balance
**Compensation, Perks, and Benefits**
We offer a competitive salary, starting at $16.50, and a comprehensive benefits package, including:
* Medical, dental, and vision insurance
* HSA account with company contribution
* Pet insurance
* Company-provided life and AD&D insurance
* Short-term and long-term disability
* Tuition reimbursement program
* Employee assistance program (EAP)
* Employee referral bonus program
* 401(k) with matching program and Roth IRA
* Company discounts
* PayActive/on-demand pay
* Paid vacation, sick days, you days, and holidays
**Conclusion**
If you're a motivated and detail-oriented individual looking to make a meaningful impact in the medical industry, we encourage you to apply for our Customer Service Representative – Medical Claims Navigation role. Join our team at careerzynith and take the first step towards a rewarding new career. Apply now and seize this opportunity to make a significant impact!
Apply for this job