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Customer Service III

3 months ago


Orlando, Florida, United States The Fountain Group Full time
Pay: $15-21/hr based on experience
Duration: 5+ month contract to start with the possibility of extension/conversion based on performance and budget
Location/Hours: Onsite in Orlando, FL; 1st shift - 8AM-4PM OR 9AM-5PM (not including lunch mins)

Responsibilities Include:
  • Takes a high volume of inbound or places outbound calls to provide information and services to customers.
  • Contacts insurance companies to verify insurance benefits; initiates pre-authorization requests for new and ongoing services with insurance companies and performs follow up activities for an outcome
  • Files Appeals for denied coverage to insurance companies as needed
  • Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care
  • Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays
  • If applicable, applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes
  • Performs other related duties as assigned
Qualifications:
  • Min. 1 yr. Knowledge of VA, Workers Comp, PA Appeals is a must
  • Understanding of Medicare rules and regulations
  • Understanding of managed care as it relates to benefits and authorizations
  • Advanced MS Office experience
  • Strong verbal and written communication skills
  • Education: min. HS diploma or GED equivalent