Customer Service Medical Rep

About the job Customer Service Medical Rep

Customer Service Medical Rep needs 2 years experience in a customer service support role is required

• Ø Knowledge in medical terminology
• Ø Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Ø Proficient interpersonal and organizational skills
• Ø Independent, Sound decision‑making and problem‑solving skills
• Ø Must be able to work in an independent and creative manner.
• Ø Self‑motivated and able to manage multiple tasks and set priorities.
• Ø Excellent oral and written communication skills
• Ø Strong interpersonal and organizational skill

• Ø Supports area clinical team and serves as a proactive resource for members related to disease prevention and benefit education.
• Ø Conduct educational telephone calls advising members of available benefits, services and programs; completes health needs assessment, and refers members to population health management programs as appropriate.
• Ø Reach out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
• Ø Manage system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries and authorization history; assigning members to clinical team for call outreach and intervention.
• Ø Facilitate research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program related inquiries