Note: The job is a remote job and is open to candidates in USA. Acentra Health is dedicated to empowering better health outcomes through technology and services. They are seeking a Customer Service Representative to assist state benefit system members and providers with inquiries regarding eligibility, benefits, and claims while ensuring a high level of customer satisfaction.

Responsibilities

• Available to work scheduled work hours based on operational needs. A shift will be assigned to you between the hours of 8:00am-8:00pm Monday through Friday
• Develop and maintain working knowledge of internal policies, procedures, and services
• Utilize automated systems to log and retrieve information; perform accurate and timely data entry
• Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times
• Respond to telephone inquiries in a prompt, accurate, and courteous manner
• Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients
• Perform verification of healthcare services to facilitate payment for received services
• Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data
• Serve as liaison between the internal and external partners
• Investigate and resolve or report provider problems
• Meet or exceed standards for call volume and service level per department guidelines
• Initiate cases by collecting and entering demographic, provider, and procedure information into the system
• Complete daily, monthly, and quarterly reports necessary for clinical team operations
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Skills

• High School Diploma or GED equivalent
• Experience with computer applications, such as Microsoft Word and PowerPoint
• Minimum of one year of call center experience
• Must live within driving distance from El Paso, TX or Tallahassee, FL
• Verbal and written communication skills, attention to detail, customer service skills
• Ability to work independently and manage one's time
• Ability to accurately document and record customer/client information

Benefits

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts

Company Overview