Medical Customer Service Representative

2 months ago


Chattanooga, Tennessee, United States Global Channel Management Full time

About the role at Global Channel Management

Job Summary:

We are seeking a highly skilled and experienced Medical Customer Service Representative to join our team. As a Medical Customer Service Representative, you will play a critical role in supporting our area clinical team and serving as a proactive resource for members related to disease prevention and benefit education.

Key Responsibilities:

  • Support Clinical Team: Provide proactive support to our area clinical team and serve as a resource for members related to disease prevention and benefit education.
  • Conduct Educational Calls: Conduct educational telephone calls advising members of available benefits, services, and programs; complete health needs assessments, and refer members to population health management programs as appropriate.
  • Identify and Address Gaps in Care: Reach out to members with identified gaps in care; encourage and motivate them to become compliant; offer assistance in locating providers and appointment scheduling.
  • Manage System Work Queues: Manage system work queues; screen identified members for eligibility, prior case activities, recent claims, customer service inquiries, and authorization history; assign members to clinical teams for call outreach and intervention.

Requirements:

  • Medicare Knowledge: Possess knowledge of Medicare and experience in a customer service support role.
  • Customer Service Experience: Have experience in customer service, with a strong focus on communication and interpersonal skills.
  • Medical Office Experience: Possess experience in a medical office setting, with knowledge of medical terminology.

Preferred Qualifications:

  • Self-Motivated: Be self-motivated and able to work independently in a fast-paced environment.
  • Effective Time Management: Possess effective time management skills and be able to prioritize tasks.
  • Strong Communication Skills: Have excellent oral and written communication skills, with the ability to communicate effectively with members and clinical teams.

Language: English (en-US)



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