Description
QUALIFICATIONS:
Must meet at least one of the following:
· High school diploma or equivalent with two (2) years customer service or medical office experience. An approved medical office assistant or medical coding certificate will substitute for one year of customer service experience.
· Two (2) years of college (at least 48 credit hours with transcript required) plus one (1) year experience in a specialized customer service environment.
· Bachelor's degree from an accredited college or university.
Excellent oral and written communication skills along with reading comprehension skills are required due to the high amount of direct customer contact and the need to understand customer contract benefits and training materials.
Must have the ability to remain diplomatic when dealing with internal and external customers.
Must demonstrate the ability to listen, type and talk simultaneously.
Excellent listening skills are required to effectively understand issues that are presented verbally from our customers.
Effective organizational and interpersonal skills are required. Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues.
Must be comfortable being monitored for level of efficiency, accuracy and customer satisfaction and must maintain the confidentiality of information encountered.
Working knowledge of relevant PC software (Microsoft Office) is required.
ACCOUNTABILITIES:
Researches several computerized systems to resolve simple to complex member and provider inquires regarding government related policies and plans that are outside standard procedure to ensure that accurate research is complete prior to execution.
Analyzes and identifies possible system errors and/or patterns and responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members and providers.
Reviews and responds to action requests accurately and promptly to ensure service level agreements, government regulations and quality assurance are in compliant, consistent, effective and efficient.
Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, HCPCS coding, ICD-9 codes, medical terminology and related computer systems to ensure information is current and accurate when providing service to members and providers.
Composes and proofreads letters to customers, group leaders, brokers, insurance companies and other plans describing payment amounts or any other written correspondence to ensure customer satisfaction.
This position reports to the Supervisor, RX Blue.
Grade: 7. Minimum starting salary: $13.28/hour.
Details:
Job Id:
1629
Annual Salary:
Position Type:
Education Level:
No Selection
Experience Level:
No selection
Posted:
11/3/2009 9:21:10 PM
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Careers & Community for Talented People with Disabilities