Note: The job is a remote job and is open to candidates in USA. Acentra Health is dedicated to empowering better health outcomes through technology and services. They are seeking a Customer Service Representative to assist state benefit system members and providers with inquiries regarding eligibility, benefits, and claims while ensuring a high level of customer satisfaction.
Responsibilities
- Available to work scheduled work hours based on operational needs. A shift will be assigned to you between the hours of 8:00am-8:00pm Monday through Friday
- Develop and maintain working knowledge of internal policies, procedures, and services
- Utilize automated systems to log and retrieve information; perform accurate and timely data entry
- Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times
- Respond to telephone inquiries in a prompt, accurate, and courteous manner
- Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients
- Perform verification of healthcare services to facilitate payment for received services
- Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data
- Serve as liaison between the internal and external partners
- Investigate and resolve or report provider problems
- Meet or exceed standards for call volume and service level per department guidelines
- Initiate cases by collecting and entering demographic, provider, and procedure information into the system
- Complete daily, monthly, and quarterly reports necessary for clinical team operations
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
Skills
- High School Diploma or GED equivalent
- Experience with computer applications, such as Microsoft Word and PowerPoint
- Minimum of one year of call center experience
- Must live within driving distance from El Paso, TX or Tallahassee, FL
- Verbal and written communication skills, attention to detail, customer service skills
- Ability to work independently and manage one's time
- Ability to accurately document and record customer/client information
Benefits
- Comprehensive health plans
- Paid time off
- Retirement savings
- Corporate wellness
- Educational assistance
- Corporate discounts
Company Overview