[Remote] Concierge Customer Service Representative
Note: The job is a remote job and is open to candidates in USA. MedWatch, LLC is seeking a Concierge Customer Service Representative to provide excellent customer interaction skills. This role involves responding to customer inquiries, assisting members with benefits and healthcare questions, and documenting all communications.
Responsibilities
- Respond to telephone and email inquiries received from members and provider within defined service standards. Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers
- Assist members with benefits and healthcare questions
- Document all 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 related 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 Microsoft 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 rate 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 Third-Party Administrator (TPA) experience
- Bilingual English-Spanish
- Understanding of Self-Funded health benefits
- Claim processing skills
- Insurance verification or pre-certification
- Provider office/facility billing department or financial area
Company Overview