Customer Service Representative

1 day ago

Woodland Hills, California, United States Pyramid Consulting Full time
Job Title: Customer Service Advocate I

We are seeking a highly skilled Customer Service Advocate I to join our team at Pyramid Consulting, Inc. This is a 12+ months contract opportunity with long-term potential and is located in a remote setting.

Job Summary:

The Customer Service Advocate I will be responsible for providing exceptional customer service to our members, addressing their concerns, and resolving issues in a timely and professional manner. The ideal candidate will have a strong background in customer service, medical administration, and utilization review or claims processing practices in a managed care setting.

Key Responsibilities:
  • Member outreach calls to address concerns and resolve issues
  • Appointment linkage and community resource connections
  • Screening for eligibility and benefits, and identifying members without a PCP
  • Screening members by priority for case management assessment
  • Transition of care duties, including contact with attending physicians, members, and medical providers
  • Coordination of services with community-based organizations
  • Attending marketing and outreach meetings to represent the plan
  • Data entry of assessments and authorizations into the system
Requirements and Technology Experience:
  • High school diploma or equivalent
  • 2-3 years of experience in a managed care setting, medical office, or facility setting with demonstration of medical administration duties
  • Thorough knowledge of customer service, utilization review, or claims processing practices in a managed care setting
  • Microsoft Word, Excel, and Outlook skills

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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