[Remote] Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. Firstsource is a company focused on Health Plan and Healthcare Services, and they are seeking a Customer Service Representative for data entry tasks. The role involves reviewing grievance and appeals documents, accurately identifying disputes, and ensuring compliance with HIPAA and data privacy requirements.ResponsibilitiesReview incoming Grievance and Appeals documents for completeness, legibility, and relevanceAccurately identify and assign the correct Line of Business (LOB) based on client and regulatory definitionsDetermine and classify the dispute type (e.g., grievance, appeal, expedited appeal, standard appeal) in accordance with client-specific guidelinesAccess multiple client systems and portals to retrieve, verify, and validate member information, including but not limited to: Member demographics Member ID numbers Plan and eligibility details Index documents by entering required data fields accurately into internal systems or client platformsNormalize and prepare documents when required to ensure all necessary information is available for downstream processingAdhere to all HIPAA, data privacy, and security requirements when handling protected health information (PHI)Meet established productivity, accuracy, and quality standardsFollow client-specific workflows, job aids, and standard operating proceduresIdentify discrepancies, missing information, or indexing issues and escalate according to established proceduresParticipate in quality audits, training updates, and process improvement initiatives as requiredSkillsFacets experience is given preference in hiringReview incoming Grievance and Appeals documents for completeness, legibility, and relevanceAccurately identify and assign the correct Line of Business (LOB) based on client and regulatory definitionsDetermine and classify the dispute type (e.g., grievance, appeal, expedited appeal, standard appeal) in accordance with client-specific guidelinesAccess multiple client systems and portals to retrieve, verify, and validate member information, including but not limited to: Member demographics Member ID numbers Plan and eligibility detailsIndex documents by entering required data fields accurately into internal systems or client platformsNormalize and prepare documents when required to ensure all necessary information is available for downstream processingAdhere to all HIPAA, data privacy, and security requirements when handling protected health information (PHI)Meet established productivity, accuracy, and quality standardsFollow client-specific workflows, job aids, and standard operating proceduresIdentify discrepancies, missing information, or indexing issues and escalate according to established proceduresParticipate in quality audits, training updates, and process improvement initiatives as requiredCompany OverviewFirstsource provides BPO solutions to organizations in banking, healthcare, telecoms, and media. It was founded in 2000, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.firstsource.com.