Healthcare Customer Service Specialist II (SCA)
New
M
MachinifyHealthcare Intelligence
Remote - USFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- At least two years’ experience in a call center or customer service position required.
- Required Skills
- Microsoft ExcelCustomer serviceData entry
Requirements
- At least two years’ experience in a call center or customer service position.
- High school diploma or GED.
- HIPAA Certification.
- Excellent verbal and written communication skills.
- Skilled in data entry and knowledge of computers.
- Working knowledge of Excel.
- Ability to learn CMS rules and regulations.
- Understanding of the CMS Recovery Audit Contractor program.
- Courteous, professional, and respectful attitude.
- Strong understanding of customer service policies and processes.
- Detailed and organized approach to managing various job duties.
Responsibilities
- Maintain current knowledge of all contract requirements and objectives.
- Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors.
- Take inbound calls from providers to answer questions and resolve complex issues.
- Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received.
- Respond to assigned written communications from providers timely and accurately.
- Educate providers on proper process protocols and their appeal rights.
- Establish appropriate contacts and perform necessary research to validate provider contact information.
- Conduct critical due diligence follow-ups if additional research or action is required.
- Enter and update all contact and activity information into tracking logs and the audit platform.
- Research and route internal/external communications to the appropriate person or department.
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