Position Description:
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.
Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Positions in this function includes those responsible for initial triage of members, administrative intake of members or managing the admission/discharge information post-notification, working with hospitals and the clinical team. Includes managing incoming calls, managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff. Manages the referrals process, processes incoming and outgoing referrals, and prior authorizations. This function includes intake, notification and census roles.
Primary Responsibilities:
- Respond to incoming provider and enrollee calls
- Resolve customer service inquiries which could include:
- Enter notifications, Providers status of an existing notification and determining if notification is required.
- Complete notification wizard along with ICD-9 and CPT coding
- Provide excellent customer service to both providers and enrollees
- Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
- Assist with faxes and emails
- Moderate work experience within own function.
- Some work is completed without established procedures.
- Basic tasks are completed without review by others.
- Supervision/guidance is required for higher level tasks.
- Moderate work experience within own function.
- Some work is completed without established procedures.
- Basic tasks are completed without review by others.
- Supervision/guidance is required for higher level tasks.
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