Job Details

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Job Summary and Responsibilities

Job Summary: The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization's services to meet productivity and quality standards.

This position is remote. Shifts will be assigned within the operating hours of 8:45 a.m. to 8:15 p.m. ET, Monday through Friday, and 9:45 a.m. to 7:15 p.m. ET on weekends and holidays.

Job Responsibilities

• Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes
• Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
• Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
• Interacts with hospitals, physicians, beneficiaries, or other program recipients
• Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party
• Meets or exceeds standards for call volume and service level per department guidelines
• Initiates files by collecting and entering demographic, provider, and procedure information into the system
• Serves as liaison between the Review Supervisors and external providers
• Maintains logs and documents disposition of incoming and outgoing calls
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications

Required Qualifications

• Requires a High School diploma or equivalent.
• Requires a minimum of two years of customer service experience.
• Bilingual (Spanish/English)

Preferred Qualifications

• Must have ability to research and resolve issues related to Medicaid program and service eligibility
• PC proficiency to include Microsoft Office Suite
• Knowledge of medical terminology.
• Knowledge of the health insurance industry.
• Effective verbal and listening skills.
• Knowledge of CPT and HCPCS codes preferred
• Bilingual Spanish-English a plus.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

Starting from USD $17.20/Hr.