Client Support Specialist

2 weeks ago

Rancho Cordova, California, United States Niahealthcare Full time

Customer Service Representative

Company: Niahealthcare

Location: Remote

Category: Customer Service

Job Overview: This role serves as a primary point of contact for Niahealthcare's members and providers, delivering assistance related to programs, policies, and procedures. The responsibilities encompass responding to incoming inquiries regarding eligibility, benefits, claims, and service authorizations from both members and providers. Additionally, this position involves managing intake documentation within the designated systems. The overarching goal is to provide exceptional service to both internal and external customers while striving to resolve inquiries on the first interaction.

Key Responsibilities:

  1. Engage with callers attentively and professionally to ascertain the purpose of their calls.
  2. Research and clearly communicate information regarding member eligibility, benefits, EAP services, claim statuses, and authorization inquiries while ensuring confidentiality.
  3. Address customer administrative issues as the initial point of contact, including resolving claims and handling complaints.
  4. Contribute to continuous improvement by identifying and reporting operational challenges and inefficiencies.
  5. Assist in the training and mentoring of new team members.
  6. Take initiative for personal development and career growth by participating in ongoing training opportunities.
  7. Accurately compile and enter patient information into the relevant delivery systems to initiate EAP, Care, and Utilization management programs.
  8. Exhibit flexibility in job duties and scheduling to enhance service delivery and support Niahealthcare's operational objectives.
  9. Educate providers on the claims submission process and the necessary documentation for treatment plans.
  10. Identify and manage crisis calls, providing ongoing support until resolution is achieved.
  11. Inform members and providers about Niahealthcare's appeal procedures.
  12. Participate in initiatives aimed at enhancing Care Center performance and fostering a positive workplace culture.
  13. Make routine referrals and triage decisions that do not require clinical judgment.
  14. Perform follow-up tasks to ensure that member or provider needs are fully addressed.
  15. Provide information on reimbursement rates and guide providers through the selection criteria and application process.
  16. Refer patients or EAP clients to the appropriate Care Management team for provider or facility connections.
  17. Stay updated on evolving information to maintain accuracy in member and provider interactions.
  18. Support colleagues and engage in team activities to cultivate a high-performance environment.
  19. Document customer interactions thoroughly and relay necessary information to the appropriate staff.

Other Job Requirements:

  • Must demonstrate flexibility in scheduling and adapt to the dynamic nature of customer service.
  • Responsible for meeting call handling metrics and daily performance standards as established by management.
  • Must consent to observe service for training and quality assurance purposes.
  • Proficient typing skills (minimum 35 WPM) with strong written and verbal communication abilities are essential.
  • Ability to navigate various computer systems while verifying information during calls.
  • Capable of multitasking by talking and typing simultaneously.

General Job Information:

Title: Customer Service Representative

Grade: 16

Work Experience: Customer Service

Education: Associates, Bachelors, GED (Required), High School (Required)

License and Certifications: Required and Preferred licenses and certifications are to be determined based on company policy.

Niahealthcare is committed to being an Equal Opportunity Employer and maintaining a Tobacco-free workplace. All employees must adhere to security responsibilities and comply with applicable legal, regulatory, and internal policies.

  • Telecom Client Support Associate

    2 weeks ago

    Rancho Cordova, California, United States Alvearium Marketing Full time

    Position Objective : The Telecommunications Support Specialist acts as a primary liaison for both individual clients and corporate entities. Our aim is to guarantee that all clients experience a superior level of assistance, addressing inquiries regarding services, and ensuring precise data management including billing and pricing, to fulfill the...

  • Client Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Pacific Office Automation Full time

    Position OverviewWe are seeking a dedicated Customer Service Representative to join our team at Pacific Office Automation. This role is essential in ensuring our clients receive exceptional support and assistance.Key ResponsibilitiesProvide outstanding customer service to clients across various platforms.Assist in resolving inquiries and issues in a timely...

  • Client Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Niahealthcare Full time

    Customer Service Role OverviewAddress and resolve client administrative issuesFoster relationships with essential health plansIntroduce cost-effective solutions into the marketplaceExplore opportunities in customer support, workforce management, claims processing, provider engagement, appeals handling, and project coordinationAbout Niahealthcare:...

  • Client Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Pacific Office Automation Full time

    Position OverviewWe are seeking a dedicated Customer Service Representative to join our team. This role is essential in providing exceptional support to our clients and ensuring their needs are met effectively.Key ResponsibilitiesDeliver outstanding customer service by addressing inquiries and resolving issues promptly.Maintain a well-organized workflow to...

  • Telecommunications Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Alvearium Marketing Full time

    Position Objective : The Telecommunications Support Specialist acts as a primary liaison for both individual clients and corporate entities. Our goal is to guarantee that all clients experience exceptional service, address inquiries regarding services, and ensure precise data management including billing and pricing, aligning with the company's mission and...

  • Client Services Specialist

    2 weeks ago

    Rancho Cucamonga, California, United States HealthCare Support Full time

    Job OverviewClient Services SpecialistHealthCare Support is in search of a Client Services Specialist to join our team. This role is essential in providing exceptional service to our members within a leading healthcare organization.Key ResponsibilitiesEfficiently manage incoming calls from members regarding authorization requests and service...

  • IT Systems Support Specialist

    12 hours ago

    Rancho Cordova, California, United States A2Zxperts Full time

    A2Zxperts is seeking a skilled IT Systems Support Specialist to join our team in providing top-notch technical support to our clients.Job Title: IT Systems Support SpecialistJob Type: ContractLocation: Remote (onsite opportunities available)Job Description:We are looking for an individual with advanced system support skills to provide effective support for...

  • Client Relations Specialist

    2 weeks ago

    Rancho Cordova, California, United States Capital Staffing Full time

    Job OverviewAre you an adept Client Relations Specialist with exceptional interpersonal skills?Do you pride yourself on being highly organized and enjoy leading initiatives?If this resonates with you, we encourage you to consider this opportunity.Compensation: $22-$25/hrWork Schedule: Monday-Friday 8am-5pmKey Responsibilities:Respond to customer inquiries...

  • Desktop Support Specialist

    4 days ago

    Rancho Cordova, California, United States West Advanced Technologies Full time

    Job SummaryWe are seeking a skilled Desktop Support Specialist to join our team at West Advanced Technologies, Inc. As a key member of our IT department, you will be responsible for providing top-notch technical support to our clients.Key ResponsibilitiesInstall, configure, and deploy Windows 10 professional desktop and laptop PCs.Install and troubleshoot...

  • Client Support Specialist

    7 days ago

    Rancho Cordova, California, United States Magellan Health Full time

    Covid-19 Update: Magellan Health is committed to the health and safety of our employees, members, providers, and customers. We take the implications of the coronavirus (COVID-19) pandemic very seriously. For more information on available resources and COVID-19, please refer to our guidelines.Vaccination Requirement: Employees in positions related to federal...

  • Technical Support Specialist

    7 days ago

    Rancho Cordova, California, United States A3 Staffing Solutions Full time

    Job OverviewPosition: Technical Support SpecialistLocation: Rancho Cordova, CAEmployment Type: Contract-To-HireWork Environment: 100% onsite in Rancho Cordova, CAExperience Required: Proficiency in Windows and some MAC systemsThis role requires a Desktop Technician II skill set, with a strong emphasis on WIN10 and O365 Outlook Support. Candidates should...

  • Desktop Support Specialist

    2 days ago

    Rancho Cordova, California, United States A3 Staffing Solutions Full time

    Job SummaryWe are seeking a highly skilled Desktop Support Specialist to join our team at A3 Staffing Solutions. As a key member of our IT support team, you will be responsible for providing exceptional end-to-end support to our users, ensuring seamless operation of our technology infrastructure.Key ResponsibilitiesTechnical Support: Provide timely and...

  • Sales and Customer Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Samra Organization Full time

    Are you a service-driven professional with a knack for sales and a preference for remote work? Samra Organization is looking for an enthusiastic Sales and Customer Support Specialist to enhance our team and contribute to exceptional service delivery while boosting sales and revenue. If you are a proactive individual with strong communication abilities, we...

  • Clinical Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Language World Services, Inc. Full time

    Position OverviewThe Clinical Support Specialist plays a vital role in enhancing patient care by assisting healthcare professionals during medical evaluations. This position involves preparing laboratory samples, conducting basic tests on-site, managing contaminated materials, and ensuring the sterilization of medical tools. The specialist is also...

  • Family Support Specialist

    2 weeks ago

    Rancho Cordova, California, United States Child Action, Inc. Full time

    Child Action, Inc. is seeking a dedicated Family Support Specialist to join our team and make a positive impact in the lives of children and families within our community. In this role, you will provide essential support services to families navigating various challenges, connecting them with resources and guidance to foster their well-being and empower...

  • Purchasing Support Specialist

    1 week ago

    Rancho Cordova, California, United States Life-Assist, Inc. Full time

    Job DescriptionAt Life-Assist, Inc., we are committed to providing exceptional support to our customers and employees. As a Purchasing Support Specialist, you will play a vital role in ensuring the smooth operation of our purchasing team.About this Opportunity:We are seeking a highly organized and detail-oriented individual to join our team as a Purchasing...

  • Purchasing Support Specialist

    7 days ago

    Rancho Cordova, California, United States Life-Assist, Inc. Full time

    Job DescriptionAt Life-Assist, Inc., we are committed to providing exceptional support to our customers and employees. As a Purchasing Support Specialist, you will play a vital role in ensuring the smooth operation of our purchasing team.About this Opportunity:We are seeking a highly organized and detail-oriented individual to join our team as a Purchasing...

  • Client Relations Specialist

    2 weeks ago

    Rancho Cordova, California, United States Five Star Bank Full time

    Job TypeFull-timeCompany OverviewFive Star Bank is a leading community financial institution with a robust asset base of $3.1 Billion, operating through multiple locations. We focus on commercial real estate and small business partnerships, delivering tailored banking solutions that foster success. Our clients choose us for our entrepreneurial approach,...

  • IT Support Specialist

    7 days ago

    Rancho Cordova, California, United States State of California Full time

    Position OverviewUnder the direct guidance of the IT Supervisor II, the selected candidate will deliver technical support and assistance to personnel utilizing computers, laptops, tablets, printers, mobile devices, and telecommunications services, along with other end-user equipment. The role encompasses a range of responsibilities related to the support,...

  • Pest Control Specialist

    2 days ago

    Rancho Cordova, California, United States Advanced IPM Full time

    **Pest Control Specialist Opportunity**At Advanced IPM, we're seeking a motivated and dependable Pest Control Specialist to join our team. As a key member, you'll be responsible for treating and preventing pest issues and infestations.Key Responsibilities:Treat and prevent pest infestations using industry-standard methods and equipment.Conduct thorough...