Customer Service

4 months ago


New York, United States Phaxis Full time
  • Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
  • Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
  • Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
  • Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
  • Provides triage and management of calls ensuring that established call performance targets are consistently achieved.
  • Provides feedback to leadership regarding training needs
  • Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
  • Participates in special projects and performs other duties as assigned.
  • Has strong organizational skills

Work Experience:
  • Minimum of two years of experience in a customer service role Required
  • Excellent oral and written communication skills Required
  • dvanced personal computer skills, including Word, Excel or Access Required
  • Utilization Management experience Preferred
  • Health care background Preferred


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