ETalentNetwork ยท 2 months ago
Non-Clinical - Administrative - Customer Service Representative
Whittier, CA
Full-time
Onsite
New Grad, Entry LevelETalentNetwork is a company that focuses on providing customer service in the healthcare sector. The Customer Service Representative will be the primary liaison for callers, addressing inquiries about healthcare issues and assisting patients in navigating health plans and services.
EmploymentRecruitingStaffing Agency
Responsibilities
Document each telephone call
Assist callers with community education questions
Provide material on screenings and promotional events that may take place with affiliated partners
Inform callers as to which health plans are affiliated with Presbyterian Health
Link (transfer) misdirected callers to PIH or the health plan if necessary
Assist members who have received claims status calls
Resolve issues by getting the specific billing information from the member and calling the provider to straighten out any billing issues
Assist providers with claims status information regarding claims payment
If a claim was denied, the provider must appeal the decision in writing
If a claim is not in the system, instruct the provider to mail the claim to the appropriate address
If a claim was processed in error, collect specific billing information and submit to Claims Supervisor for investigation
Assist members and providers with referral authorization status
Assist member, provider, and health plan with eligibility status
Compiles materials for mailings to callers upon request
Works in the spirit of cooperation and understanding with management other staff members
Attends and participates in staff meetings as required
Ensures compliance with established departmental and organizational policies and procedures
Keeps workspace in a neat and organized way
Ensures that confidentiality of all sensitive information affecting the Company's finances or public image is properly safeguarded
Any and all other tasks as assigned by manager
Qualification
Required
High school graduate or equivalent required
Experience working with telephone callers, preferably in a healthcare setting, or the ability to demonstrate the aptitude for such work
Training or experience in a Microsoft Windows environment required
Self-motivated
Positive attitude
Excellent verbal and written skills
Ability to learn quickly
Possess strong computer skills
Deal effectively in a fast-paced, changing environment
Good organizational skills
Ability to work independently as well as be part of a team
Develops effective working relationships with all levels of the organization, including administration, doctors, and staff
Ability to identify and solve problems
The ability to talk to callers in all walks of life and in all situations via telephone and build a sense of trust and rapport with the caller and intent of the call
The ability to understand the requirements of a substantial number of health plans, in order to assist patients in selecting a physician, accessing services, and resolving billing issues
The ability to record information, in a database, accurately and rapidly
Respond to caller inquiries by summarizing what is often confusing and difficult to understand information
The ability to perform well in a teamwork environment and to maintain a positive attitude in a busy and high-pressure work situation
The demonstrated ability to speak and write in articulate and grammatically correct English
Preferred
Data entry experience preferred
Conversing in Spanish or Chinese if identified in the specific position requirements
Company
ETalentNetwork
E Talent Network is an Recruitment Process Outsourcing company specializes in Staffing and Recruiting.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase