Customer Service Representative

3 weeks ago

Norfolk, Virginia, United States Elevance Health Full time
Job Title: Case Coordinator

Elevance Health is a leading health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

Job Summary:

We are seeking a highly organized and detail-oriented professional to coordinate cases for precertification and prior authorization review, manage incoming calls and claims work, and provide authorization for inpatient admission, outpatient precertification, and post-service requests.

Key Responsibilities:
  • Manage incoming calls and claims work, determining contract and benefit eligibility
  • Provide authorization for inpatient admission, outpatient precertification, and post-service requests
  • Refer cases requiring clinical review to a Nurse reviewer
  • Identify and data enter referral requests into the UM system
  • Respond to telephone and written inquiries from clients, providers, and in-house departments
  • Conduct clinical screening process and authorize initial set of sessions to provider
  • Check benefits for facility-based treatment
  • Develop and maintain positive customer relations and coordinate with various functions within the company
Requirements:
  • High school diploma/GED
  • 1 year of customer service or call-center experience
  • Proficient analytical, written, and oral communication skills
  • Medical terminology training and experience in medical or insurance field preferred
  • Reliable, fast work pace, and independent
  • Candidate needs to be able to multitask and be familiar with MS Teams, Excel, Word, and Outlook
About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

About BCforward:

BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. We champion the power of human potential to help companies transform, accelerate, and scale.

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