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Healthcare Customer Support Specialist
2 months ago
Position Title: Customer Service Representative (Medical)
Job Category: Administrative/Technical
Job Overview:
In this role, you will operate under limited supervision, engaging in a range of tasks to support a designated project or technical unit. Your responsibilities will include gathering, collecting, recording, tracking, and verifying data from various sources. You will utilize software specific to your functional area to manage appointments and document activities within the case management systems. Additionally, you will compile and generate reports, statistics, timelines, tables, graphs, correspondence, and presentations. Providing exceptional customer service at all interaction points is a critical aspect of this position.
Key Responsibilities:
- Handle incoming calls from an automated call distribution system.
- Prioritize daily referrals and ensure that appropriate worksheets are allocated to the corresponding conditions as identified by the relevant authorities.
- Confirm that the correct CPT and CLIN codes are assigned to each case.
- Engage directly with claimants and healthcare providers.
- Collect medical histories for specified conditions.
- Identify necessary examinations, tests, and specialists for each case.
- Coordinate appointments for examinees, including follow-ups and rescheduling.
- Ensure all examinees and providers receive the required documentation.
- Verify that consultative reports and diagnostic test results are received promptly.
- Adhere to contract timeliness guidelines in both scheduling and case management systems.
- Perform additional projects and duties as assigned.
Required Competencies:
- Strong organizational and planning skills.
- Adept at managing competing priorities in a dynamic work environment.
- Excellent follow-through capabilities.
- Flexibility to work early mornings, evenings, and/or weekends as needed.
Qualifications:
Successful candidates must pass a National Agency Check with Inquiries (NACI) background investigation. This job description is intended to outline the general content and essential requirements for the position and is not exhaustive of all duties and responsibilities. Management reserves the right to modify the duties of this position as necessary.
About QTC Management:
QTC Management Inc. is an Equal Opportunity Employer and a VEVRAA Federal contractor. We are committed to affirmative action and fostering a workplace free from discrimination, harassment, and retaliation. We value diversity and promote individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, sexual orientation, disability status, or veteran status.
Skills Required:
- Written Communication: Intermediate
- Verbal Communication: Intermediate
- Computer Literacy: Intermediate
Preferred Skills:
- Problem Solving: Intermediate
- Medical Documentation: Intermediate
- Customer Service: Intermediate
- Multi-line Phone: Advanced
- MS Office: Intermediate
- Medical Scheduling Software: Intermediate
- Medical Terminology: Intermediate
- Medical Data Entry: Intermediate
- Electronic Medical Records: Intermediate
Education:
High School Diploma or GED is required.
Experience:
Less than 1 year of experience in healthcare, medical, or insurance-related industries is required. Direct healthcare experience in medical case management or quality assurance is preferred.
