Member/Provider Service Rep

Columbus, Ohio

Intro:

Are you an experienced Member/Provider Service Representative looking for a new opportunity with a prestigious healthcare company as a Member/Provider Service Rep? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes” to any of these questions – this is the position for you!

Position Summary:

Receive and respond to member/customer inquiries via telephone and written correspondence in a timely and professional manner.

Responsible for resolving provider inquiries via telephone and email correspondence in a timely and appropriate manner. Provider inquiries including claims, eligibility, covered benefits, authorization status issues

Hours for this Position:

Must be available between 8-7pm with no scheduling conflicts

Advantages of this Opportunity:

• Competitive salary
• Fun and positive work environment
• Opportunity for advancement

Required Skills

What We Look For:

• 1 Year Healthcare Experience
• Assoiciates Degree Preferred
• Call Center Experience a must

Responsibilities

More Insight of Daily Responsibilities: 

• Document all activities for reporting and resolution through the customer relationship management application (CRM)

• Answer inquiries from providers regarding claim, eligibility, covered benefits, authorization status issues

• Provide first call resolution through issue documentation and resolution with appropriate internal resource, follow-up and ensure closure with the contact who initiated the inquiry

• Respond appropriately to provider issues and concerns, and provide trending feedback to improve the customer experience

• Process customer correspondence and provide the appropriate level of timely follow up

• Manage service related follow up items and outstanding tasks in accordance with established turnaround times

• Provide assistance to provider regarding website registration, navigation and customer related inquires

• Educate provider on health plan initiatives during interactions with providers via telephone

• Maintain performance and quality standards based on established call experience guidelines

• Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations’ team for claim adjustment

• Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction

Want More Information?

Interested in hearing more about this great opportunity? Reach out to Ryan Chojnacki at rchojnacki@healthcaresupport.com for immediate consideration.
Why You Should Work For Us:

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Salary

Based on Experience HR 13-15