Personally Yours Staffing seeks a Night Shift Call Center Representative for company located in the Downtown area.
Some of the main daily duties and responsibilities are, but not limited to:
Direct communications with customers, clients, providers and potential clients via phone, email and any type of communication.
Documentation of all calls or communications in the members record (when applicable)
Confirmation of benefits and eligibility information to members and providers.
Ensure that providers send claims for processing and/or payment and that only the correct amounts are collect from the patient (deductible, co-payments, etc.) Assignment of benefits
Provide referrals to in network providers to all members, clients and sometime other providers, confirmation of participation of a specific provider in the network. Steer callers to in network facilities/providers to generate higher revenue.
Provide claims information like status, process date, detailed payment amount, check number, discounts taken, etc. to members, clients and providers by making the necessary contacts.
Assist on resolving any billing issue by contacting the appropriate department and/or parties involved.
Identify balance billing by analyzing claim and payment information available.
Identify potential problems and take prompt corrective actions in order to avoid escalated issues that require supervisory intervention.
Keep account managers informed of any delicate issue that may require their attention in order to avoid or resolve an existing problem.
Calm irate members and providers and reassure their problems and concerns will be dealt with in an effective and timely manner.
Apply knowledge, experience, common sense, and critical thinking to all issues being dealt with. Multi task and prioritize
Make decisions on when a specific issue needs to be brought to the attention of the supervisor/manager.
Respond and address new business concerns from existing and potential customers.
Log and record all type communications for patient files.
Respond to general queries from members (policy procedures, reimbursements, etc.). Redirect callers when necessary
Follow up until completion on all issues that are not resolved on the initial contact, keep parties up dated on steps and actions taken.
Service the maximum amount of callers in the quickest and most efficient way with out sacrificing the quality of the service.
Coordination of medical appointments, this, in most cases, include locating and contacting several participating providers who have the availability and suit the patients preferences concerning location, language, etc.
Preferred and required skills:
Candidate must be fully Bilingual with clear communication skills in English and Spanish, as they will be dealing with the Latin American market. No degree is necessary, requires 2 or more years experience in related field. A call center representative must posses critical thinking skills as well as the ability to manage time efficiently, must be able to gather the information necessary to assist customers, call center representatives need to always be sharp and alert, needs to communicate well with co-workers (verbal and written), professionalism, able to understand, interpret and explain policies and procedures as well as knowledge of commonly used concepts, practices and procedures in the field, ability to deal with irate customers and complaints while maintaining composure and control of the situation, some degree of computer expertise, knowledge of phone manners, etiquette.
Personally Yours Staffing - 2 years ago