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Healthcare Customer Service Representative

Collabera
Newark, NJ
  • Expired: over a month ago. Applications are no longer accepted.
Job Description
We Are Hiring for Customer Service at Newark, NJ
Client: Healthcare
Title: Managed Care Coordinator/ Customer Service Representative
Location: Newark, NJ
Duration: 06 Months (possibility of extension or conversion)
Responsibilities:
  • Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.
  • Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.
  • Prepare, document and route cases in appropriate system for clinical review.
  • Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.
  • Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.
  • Reviewing professional medical/claim policy related issues or claims in pending status.
  • Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening.
  • *Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information.
Required Skills:
• Requires knowledge of medical terminology.
Desired Skills:
• Prefer 1-2 years customer service or medical support related position.
• Prefer knowledge of contracts, enrollment, billing & claims coding/processing.
• Prefer knowledge Managed Care principles.
• Prefer the ability to analyze and resolve problems with minimal supervision.
• Prefer the ability to use a personal computer and applicable software and systems.
• 1-2 years customer service or medical support related position.
Education:
High School Diploma required. Some College preferred.
Managed Care,Customer Service,Customer Service Representative,Healthcare Customer Service,Medical Customer Service,Patient Care,Administrative Assistant,Healthcare Admin

Collabera

Address

Newark, NJ
07105 USA

Industry

Healthcare

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