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Call Center Rep

Firstech/FirstMed Madison, WI
  • Expired: 29 days ago. Applications are no longer accepted.

Call Center Rep - SUMMARY:

Provide excellent service in response to requests or questions from providers of service; anticipating and proactively informing and educating them on the benefit plan, pre-authorization requirements, and network status requirements while sharing any other information relevant to the subject at hand.

Call Center - ACCOUNTABILITIES:
90% -- Inbound Customer Inquiries:

• Receive/respond to member telephone inquiries about their benefits/eligibility; explaining how to receive maximum benefit reimbursement.

• Anticipate and proactively inform and educate members regarding their benefit plans, preauthorization requirements; verifying network status and steering to high value providers while sharing any other information relevant to each call or situation that could negatively affect the member experience and/or their out of pocket costs.

• Own and research calls to completion and resolution, ensuring member satisfaction.

• Inform members about and facilitate the referral and preauthorization process.

• Review and determine which policy provisions, guidelines, medical review requirements, and/or procedures of other Trust departments apply to the member’s need or concern.

10% Projects:

• Perform special projects and assignments including, but not limited to, testing online system changes and enhancements; as well as suggesting system improvements.

REQUIRED EXPERIENCE AND KNOWLEDGE: REQUIRED EXPERIENCE AND KNOWLEDGE:
• 2 + years of experience working in the health care industry, including three years of experience working in a call or customer care center that required interaction with customers in situations where the customer was not always satisfied.

• Knowledge of insurance and medical terminology.

PREFERRED EXPERIENCE AND KNOWLEDGE:
• Experience working in eligibility, enrollment, or billing with knowledge of eligibility and enrollment and administrative practices and procedures.
• Experience communicating benefit determinations and to subscribers and providers.
• Knowledge of medical terminology and diagnostic/procedure codes.

• Experience utilizing Microsoft Word, Excel, and Outlook; HealthRules; Data Dimensions, and other

Firstech/FirstMed

Why Work Here?

FirstMed offers competitive wages/bonuses that demonstrate an appreciation for their employees while creating work/life balance!!

Address

Madison, WI
USA