Customer Service Representative

4 weeks ago

Tampa, Florida, United States Acentra Health Full time
Job Summary

The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization's services to meet productivity and quality standards.

Key Responsibilities
  • Develops and Maintains Working Knowledge: Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational).
  • Utilizes Automated Systems: Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes.
  • Responds to Customer Inquiries: Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times.
  • Provides Excellent Customer Service: Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures.
  • Interacts with Hospitals and Providers: Interacts with hospitals, physicians, beneficiaries, or other program recipients.
  • Investigates and Resolves Customer Problems: Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party.
  • Meets Productivity and Quality Standards: Meets or exceeds standards for call volume and service level per department guidelines.
  • Initiates Files: Initiates files by collecting and entering demographic, provider, and procedure information into the system.
  • Serves as Liaison: Serves as liaison between the Review Supervisors and external providers.
  • Maintains Logs and Documents: Maintains logs and documents disposition of incoming and outgoing calls.
Requirements
  • High School Diploma or Equivalent: High School diploma or equivalent.
  • Customer Service Experience: 2+ year's customer service/telephone experience in a similar call center environment and/or industry.
  • Effective Communication Skills: Must have ability to effectively communicate with team members and external customers.
  • Research and Problem-Solving Skills: Must have ability to research and resolve issues related to Medicaid program and service eligibility.
  • Bilingual: Bilingual (Spanish/English).
Preferred Qualifications
  • Previous Experience in Medical Office: Previous experience in the medical office or other medical setting preferred.
  • General Knowledge of Eligibility Verification: General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred).
  • Knowledge of CPT and HCPCS Codes: Knowledge of CPT and HCPCS codes preferred.
  • PC Proficiency: PC proficiency to include Microsoft Office Suite.
  • Experience with Microsoft Programs: Experience with Microsoft programs.
Why Choose Acentra Health

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

The pay range for this position is $15.85 - $18.20. Based on our compensation program, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

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