Provider Customer Service Representative
Description:
Answers questions and resolves issues based on phone calls/letters from providers.
Provide excellent customer services for high volume inbound provider calls.
Extensive claims research on multiple platforms.
Uses customer service threshold framework to make financial decisions.
Processes claim referrals, new claim handoffs, nurse reviews, and provider complaints.
Educates & assists providers on our self-service options.
Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility.
Performs review of member and provider claim history.
Requirements:
Familiarity with Microsoft Office products
Excellent computer skills using multiple screens and systems
Experience in highly transactional call center environment
Excellent customer service and critical thinking
Secure, private home office location
High speed internet access (100 mbps or higher)
Benefits:
Full range of medical, dental, and vision benefits
401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance
Short-term and long-term disability benefits
Well-being programs
Education assistance
Free development courses
CVS store discount
Paid Time Off (PTO)
Paid holidays
Apply Now
Answers questions and resolves issues based on phone calls/letters from providers.
Provide excellent customer services for high volume inbound provider calls.
Extensive claims research on multiple platforms.
Uses customer service threshold framework to make financial decisions.
Processes claim referrals, new claim handoffs, nurse reviews, and provider complaints.
Educates & assists providers on our self-service options.
Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility.
Performs review of member and provider claim history.
Requirements:
Familiarity with Microsoft Office products
Excellent computer skills using multiple screens and systems
Experience in highly transactional call center environment
Excellent customer service and critical thinking
Secure, private home office location
High speed internet access (100 mbps or higher)
Benefits:
Full range of medical, dental, and vision benefits
401(k) retirement savings plan
Employee Stock Purchase Plan
Fully-paid term life insurance
Short-term and long-term disability benefits
Well-being programs
Education assistance
Free development courses
CVS store discount
Paid Time Off (PTO)
Paid holidays
Apply Now