Customer Service Representative

Customer Service Representative (Remote)

Remote United States

Operations

Full time

CSRSCA

Description

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Customer Service Representative (Remote)

• Are you an experienced Customer Service Representative looking for a new challenge?
• Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

If so, you might be our next new team member!

Who we need:

A Customer Service Representative to provide support by:

• Answering incoming telephone calls
• Resolving customer questions and complaints and requests
• Adhering to internal policies and procedures
• Utilizing working knowledge of the organization’s services to meet productivity and quality standards.

Why us?

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.

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

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.

What you’ll do:

• Establish a client record for all applicants.
• Handle and track queries from providers and members related to program and service eligibility and resolves issues or refers to appropriate parties for resolution within established timelines.
• Answer telephones, screen and direct calls appropriately.
• Process/generate correspondence related to program and service eligibility and prior authorization of services within specified timelines and completes required tracking.
• Research, investigate and assist providers to ensure appropriate resolution and tracking of inquiries related to prior authorization status and documents activities per established protocols.
• Document and log inquiry and complaint information within established timelines and protocols.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications

• Requires High School Diploma or equivalent; (Associates or Bachelor’s Degree in Human Services Field preferred)

Knowledge, Skills, Abilities

Knowledge:

• General knowledge of office environment and business processes
• General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
• Knowledge of CPT and HCPCS codes preferred
• PC proficiency to include Microsoft Office Suite

Skills:

• Excellent verbal and written communication skills
• Basic data entry skills
• Excellent customer service skills
• Ability to meet Departmental standards and established workload standards
• Ability to work well with management and team members to contribute to the achievement of departmental goals
• Ability to multi-task
• Strong organization skills
• Experience with Microsoft programs

Abilities:

• Must have ability to effectively communicate with team members and external customers
• Must have ability to research and resolve issues related to Medicaid program and service eligibility

Experience

• 1+ year(s) of experience in an administrative support or customer service position
• Previous experience in the medical office or other medical setting preferred