Customer Service Representative (Remote)

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Requirements:

• High School diploma or equivalent.
• 2+ years customer service/telephone experience in a call center environment or similar industry.
• Ability to communicate effectively with team members and external customers.
• Ability to research and resolve Medicaid program-related issues.
• Preferred: experience in a medical office setting.
• Preferred: knowledge of Medicaid eligibility and program requirements.
• Preferred: knowledge of CPT and HCPCS codes.
• PC proficiency, particularly in Microsoft Office Suite.

Responsibilities:

• Develops and maintains working knowledge of internal policies, procedures, and services.
• Utilizes automated systems to log and retrieve information; performs accurate data entry of electronic faxes.
• Receives inquiries from customers/providers via phone, email, fax, or mail, and responds within required times.
• Handles calls promptly and courteously, following standard operating procedures.
• Interacts with hospitals, physicians, beneficiaries, or other program recipients.
• Investigates and resolves customer problems, escalating difficult situations as needed.
• Meets/exceeds call volume and service standards.
• Initiates files by collecting and entering relevant information into the system.
• Acts as a liaison between Review Supervisors and external providers.
• Maintains logs and documents disposition of calls.