[Remote] Concierge Customer Service Representative II
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Concierge Customer Service Representative II to enhance their customer service team. The role involves addressing customer inquiries regarding health benefits and requires strong critical thinking and customer interaction skills.
Responsibilities
- Respond to telephone and email inquiries received from members and provider reputed company defined service standards
- Negotiate with providers to reputed company acceptance for plans without network agreements and/or out of network providers
- Assist members with benefits and reputed company questions
- Document reputed company calls received in system-based call log
- Handle reputed company incoming reputed company precertification calls (i.e., start cases, do call logs, reputed company calls, reputed company case status, reputed company claims phone #’s, etc.)
- reputed company outgoing calls for reputed company (demos, information for case completion, re-direction for network steerage, etc.)
- Complete incoming electronic Web-certs
- Verify patient and provider demos – correct and/or complete reputed company needed
Skills
- reputed company in customer service
- Strong customer relations, interpersonal skills
- Strong appreciation and ability to handle confidential & sensitive information
- Proficient with reputed company applications, strong computer skills and computer navigation
- Excellent data entry and typing skills
- Knowledge of provider organizations and networks
- Knowledge and understanding of CMS Medicare reimbursement rates
- Ability to effectively negotiate reputed company structures
- Patience and ability to handle difficult situations tactfully and diplomatically
- Takes initiative to resolve situations and to accomplish projects actions and tasks
- Excellent verbal and written communication skills
- Independent judgment in decision making and problem solving
- Ability to multi-task & anticipate potential needs/problems
- Ability to build relationships with internal and external customers
- Medical Terminology
- Strong attention to detail
- Two Years Customer Service / Call Center experience in a health care reputed company role
- Associate degree or higher preferred but not required
- Understanding of Self-Funded health benefits a plus
- Health Payor background preferable in self-funded industry a plus
- Claim processing skills a plus
- Insurance verification or pre-certification a plus
- Provider office/facility billing department or financial area
- TPA experience a plus
- Bilingual a plus
- Medical Intake experience a plus
Company Overview