Experienced Customer Service Representative - Provider Support and Advocacy – Remote Opportunity at careerzynith

Remote Full-time
At careerzynith, we are dedicated to simplifying the healthcare experience and creating healthier communities. As a leading health insurance provider, we are committed to delivering exceptional service to our members and partners. We are seeking an experienced Customer Service Representative to join our team as a Provider Customer Service Call and Chat Representative. In this role, you will play a crucial part in supporting providers who care for our members, ensuring they have a seamless and efficient experience with our services.

**About the Position**

As a Provider Customer Service Call and Chat Representative, you will be the advocate for providers, demonstrating accountability and ownership in resolving issues. You will engage with providers in a multi-channel environment, including calls and chats, and will be responsible for triaging contacts from healthcare professionals, understanding their needs, and providing timely resolutions to their inquiries. In this role, you will research and dissect complex prior authorization and claim issues, collaborating with multiple internal partners to ensure effective communication and resolution.

**Responsibilities**

As a Provider Customer Service Call and Chat Representative, your key responsibilities will include:

* Serving as the advocate for providers by demonstrating accountability and ownership to resolve issues.
* Serving providers in a multi-channel environment, including call and concurrent chat as required.
* Quickly and appropriately triaging contacts from healthcare professionals (i.e., physician offices, clinics, billing offices).
* Seeking to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).
* Researching and dissecting complex prior authorization and claim issues and taking appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.
* Collaborating effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.
* Demonstrating strong multitasking skills to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.
* Influencing providers to utilize self-service digital tools, assisting with navigation questions and selling the benefits of the tool, including aiding in faster resolution.

**Requirements**

To be successful in this role, you will need to possess the following qualifications:

* High School Diploma / GED OR equivalent work experience.
* 1+ years of customer service experience with analyzing and solving customer's concerns.
* Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
* Ability to type at the speed of greater than or equal to 35 - 40+ WPM with an accuracy of 90%.
* Must be 18 years of age or older.
* Ability to work any full-time (40 hours/week), 8-hour shift between the hours of 10:35 AM - 7:05 PM CST from Monday - Friday.

**Nice-to-Haves**

While not required, the following qualifications would be beneficial in this role:

* Prior healthcare experience and knowledge of healthcare terminology.
* Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.

**Benefits**

As a valued member of the careerzynith team, you will enjoy a comprehensive benefits package, including:

* Comprehensive benefits package
* Incentive and recognition programs
* Equity stock purchase
* 401k contribution

**Work Environment and Culture**

At careerzynith, we are committed to creating a work environment that is inclusive, supportive, and empowering. Our team is dedicated to delivering exceptional service to our members and partners, and we are seeking like-minded individuals to join our team. As a remote employee, you will have the flexibility to work from the comfort of your own home, while still being part of a dynamic and collaborative team.

**Career Growth Opportunities and Learning Benefits**

careerzynith is committed to the growth and development of our employees. We offer a range of training and development opportunities, including:

* 12 weeks of paid training, conducted virtually from home, with training hours set from 8:00 AM to 4:30 PM CST, Monday through Friday.
* Ongoing training and development opportunities to enhance your skills and knowledge.
* Career growth opportunities within the company, with a focus on promoting from within.

**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 be in touch to discuss your qualifications further.

**Apply Now!**

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