Customer Service Representative
New
United States, Monday-Friday 1.30pm-10.00pm ESTFull-TimeEntry
Salary29,120 USD per year
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Job Details
- Required Skills
- Data entry
Requirements
- Ability to adhere to HIPAA, data privacy, and security requirements.
- Proficiency in accurately indexing data fields into systems.
- Capability to identify and classify complex grievance/appeal types.
- Attention to detail for document verification and validation.
- Capacity to meet productivity and quality standards in a high-volume environment.
Responsibilities
- Review incoming Grievance and Appeals documents for completeness, legibility, and relevance.
- Accurately identify and assign the correct Line of Business (LOB) based on client and regulatory definitions.
- Determine and classify the dispute type in accordance with client-specific guidelines.
- Access multiple client systems and portals to retrieve, verify, and validate member information.
- Index documents by entering required data fields accurately into internal systems or client platforms.
- Normalize and prepare documents when required to ensure all necessary information is available for downstream processing.
- Adhere to all HIPAA, data privacy, and security requirements when handling protected health information (PHI).
- Meet established productivity, accuracy, and quality standards.
- Follow client-specific workflows, job aids, and standard operating procedures.
- Identify discrepancies, missing information, or indexing issues and escalate according to established procedures.
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