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Member Service Representative

New Leaf Staffing, Inc Pasadena, CA
  • Posted: over a month ago
  • $16 to $18 Hourly
  • Full-Time
  • Benefits: Vision, Medical, 401k, Dental

Member Services/Customer Service Reps

Bilingual Spanish, Chinese, Vietnamese

SUMMARY

Under general supervision, following established procedures, assist and direct patients and or providers in an empathetic and caring manner, efficiently and timely, and complete appropriate documentation. Respond to provider inquiries and attempt to resolve provider concerns or refer to management for resolution.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Comply with UM, Claims, Member Services policy and procedures.
  • Read all new P&P’s and review others annually as needed
  • Answer incoming calls from our customers to include but not limited to: members, providers, health plans, insurance brokers, and hospitals in accordance with HIPAA guidelines.
  • Research and resolve authorizations, claims, eligibility inquiries and any additional concerns in a timely fashion.
  • Accurate documentation of calls into customer service module using appropriate wrap up codes.
  • Educate contracted providers about TAT’s, Portal access and other information as needed, document provider education in customer service module

QUALIFICATIONS:

  • High School Graduate or equivalent
  • A minimum of one-year Healthcare related experience in managed care environment to include but not limited to an IPA, MSO or health plan preferred
  • Current knowledge of Managed Care UM and Claims procedures
  • Knowledge of medical terminology, CPT, HPCS, ICD-10 codes
  • Proficient with Microsoft applications
  • Must be able to Type 40 or more WPM
  • Bilingual spanish, chinese, vietnamese

New Leaf Staffing, Inc

Why Work Here?

Our Collaborative Process allows us to focus on our employees' needs while matching them to a career opportunity with growth!

New Leaf Staffing, Inc. is a healthcare staffing and consulting company specialized in providing our clients with highly qualified and professional personnel on a contract, contract to hire and direct hire basis. What sets us apart from the competition is that with over 50 years of combined experience in Healthcare Staffing we have a proven system in place to provide our clients with the most experienced & professional personnel they need to thrive and to provide our candidate employees with the career of their dreams. To our Employers Our interest is in partnering with you through a collaborative process that will provide you with the perfect candidates who will not only be motivated and highly qualified but will also be a fit with your company culture. We are not interested in just providing you with a warm body to punch a time clock, so to insure we are providing you with the most professional and qualified personnel available, we first perform an intensive candidate analysis profile which enables us to then present you with a project outline of our extensive screening and testing processes, resulting in a final candidate presentation of 2 or 3 exceptional candidates who will already be a skill and personality match for your facility. To our Candidates We are unlike any other agency you may have worked for in the past, as we view you as our most valuable resource and partner. You are the face and lifeblood of our company; therefore, from the very first time you have contact with one of our recruiters you will be treated with the respect and courtesy you deserve. Not only do our professional recruiters have the interest of our clients in hand but they also have your best interests at heart. Our interest lies in placing you in a fulfilling career that will give you room for growth, stability and success. Thank you for allowing New Leaf Staffing the opportunity to serve you. New Leaf Staffing.... "Placing the right professional in the right career with the right company" www.newleafstaff.com

Address

Pasadena, CA
USA

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