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Group Health PRN Customer Service Representative
Posted 4 days agoViewed
Requirements:
- An Associate’s Degree is preferred.
- Business experience in a healthcare and/or insurance setting is preferred.
- Present exceptional communication skills with a clear understanding of company business lines.
- The ability to apply critical thinking, manage time efficiently and meet specific deadlines.
- Computer literacy and typing skills are essential.
Responsibilities:
- Intake new cases and review/verify information and requests.
- Draft cases by entering information into the Dane Street system, AccessDS.
- Work with client on any information missing pertinent to processing claim.
- Sort, organize and create medical document listing - if required by client, and in line with specific special handling.
- Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
- Ensure that the assigned physician has no conflict of interest with the case assignment.
- Monitor, process and track cases to ensure we meet deadlines.
- Update clients frequently on cases in progress.
- May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
- Ensure proper documentation for specified cases is provided to the client.
- Other duties & special projects, as assigned and based on business needs.
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