Customer Service Representative for CRC

InspiriTec

Customer Service Representative  

CMS MSP CRC 

 General Function 

The Commercial Repayment Center (CRC) is part of the Centers for Medicare & Medicaid Services (CMS) Medicare Secondary Payer suite of programs. The CRC helps the CMS protect the Medicare Trust Fund by recovering debts owed by commercial insurers thereby protecting Medicare for future generations. These debts occur because Medicare has paid for medical/health care that is to be covered by the commercial insurer.

Under general supervision the CRC Support management, the Customer Service Representative  (CSR) will respond to inquiries from commercial entities about the secondary payer processes, including any correspondence sent out about the potential debt.  Proper verification, and validation are required to identify each caller, and ensure right party contact in order to protect confidential information.  CSR's will leverage the Benefits Coordination & Recovery (BCRS) system to access, process, and update caller information. Additionally, CSR's will utilize knowledge attained through training on the MSP Coordination of Benefits Recovery (MSP COB&R) program to analyze caller issues, and present the necessary information in order to serve callers. Other responsibilities may include handling e-mail requests, correspondence requests for the following BCRS Work Types: Authorizations (aka "Letter of Authorization"), QA Portal Authorizations (including weekly and monthly reporting), Incoming Status Letters ("ISLs"), and Call Center Escalations. Document and track support activity, and clearly communicate responses in a customer centric manner. Candidate may be assigned other duties.  Expertise in customer care and analytical skills are needed to accurately understand a caller's issue, and provide a timely and accurate response.  

 Essential Duties & Responsibilities 
 
The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to this position. 

 
• Assist callers with all aspects of the MSP Coordination of Benefits Recovery (MSP COB&R) program.

• Ability to listen, interpret various types of caller feedback, and ask appropriate questions to uncover the proper solution or resolution response. 

 
• Collaborate effectively with other CRC staff members, leaders, and trainers to resolve unfamiliar issues. 

• Advise users on appropriate action and turnaround times if the information is available, as well as follow up with them accordingly to provide the requested information once received. 

• Log all calls, emails, and voicemails into the CRM for tracking purposes. 

• Follow Standard Operating Procedures (SOP). 

• Identify and escalate situations requiring urgent attention or expert knowledge to appropriate Subject Matter Experts.

• Route problems, create, track and document resolutions. 

• Stay current with system information, changes and updates by attending CRC staff meetings. 

• Respond to incoming requests for assistance via calls, emails, or ISL's 

• Work on supervisor-assigned projects when requested. 
 

 Knowledge, Skills and Abilities required: 

• Excellent customer care skills.

• Strong verbal and written communication skills.

• Superior interpersonal skills and telephone etiquette.

• Good analytical and problem-solving skills.

• Ability to deal with stress associated with fast-paced work environment.

• Ability to make judgment decisions and adapt to changing work situations.

• Ability to handle 50+ calls per day with calls being different in level of complexity

• Ability to work independently, as part of a team, with customers, peers and management

• Proficient in Microsoft Office Suite and various Windows operating systems.

• Willingness to work flexible hours 8am to 8pm, M-F. 

Physical and Mental Demands 

The physical and mental demands described here are representative of those that must be met by employees to successfully perform the essential functions of this class. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. You will be regularly required to sit, talk or hear in person and by multi-media, use hands to finger, handle, feel or operate standard office equipment and reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.

While performing the duties of this class, employees are regularly required to effectively use written and oral communication skills; read and interpret data, information and documents; analyze and solve problems; use math and mathematical reasoning; learn and apply new skills and information; perform highly detailed work on multiple, concurrent tasks; and interact with Colleagues, Clients and Vendors, and must maintain composure in a fast paced, high quality environment where personal and team accountabilities are the defining factors.  

EEO/disability/vets