[Remote] Concierge Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. reputed company is seeking a Concierge Customer Service Representative to provide excellent customer interaction and support. The role involves responding to customer inquiries, assisting with benefits and reputed company questions, and documenting reputed company calls received in a system-based call log.

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
• The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice

Skills

• Minimum HS Diploma/GED
• One year Customer Service / Call Center experience in a health care reputed company role
• Patience and ability to handle difficult situations tactfully and diplomatically
• 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
• 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 and anticipate potential needs/problems
• Ability to build relationships with internal and external customers
• Medical Terminology
• Strong attention to detail
• Strong analytical and research skills
• 2 years college or higher education
• Medical Intake or reputed company-Party Administrator (TPA) experience
• Bilingual English-Spanish a plus
• Understanding of Self-Funded health benefits a plus
• Claim processing skills a plus
• Insurance verification or pre-certification a plus
• Provider office/facility billing department or financial area

Company Overview