Remote Customer Service Representative

About the job REMOTE CUSTOMER SERVICE REPRESENTATIVE

Customer Service Representative (Remote)

Are you an experienced Customer Service Representative looking for a new challenge?

Do you value customer service and helping your community?

Are you motivated, energetic, and excited to become part of the team?

If so, you might be our next new team member!

Fully remote position, where you can work from home. Rotational shifts available for EST, CT or PST.

Full benefits (medical, dental, vision, etc.) effective the first month following your hire date!

Paid time off for great work life balance

401k with match with no vesting period

A Customer Service Representative to provide all customer service support for the Review Team including but not limited to the following activities:
Interacting with beneficiaries and providers via the helpline, creation, formatting and proofreading of letters as well as maintaining timeliness. This position requires a great deal of decision making in regard to more different types of complex appeals.

Responsible for typing/merging, proofing for clarity, printing, and mailing correspondence.

Communicate verbally and in writing with external customers to furnish and request review information.

Foster effective working relationships between our internal and external customers.

Assist with and participate in Review Team in identifying areas for potential improvement, as noted on case reviews and process.

Answer the Beneficiary Helpline through the utilization of the hunt group and available light functions.

Determine how to best assist caller either by a service offered or by referring them to an external agency and properly enter referral into CMS system.

All letters sent out in timely manner with correct components included and reviewed for grammatical and spacing errors.

Get and validate notices and all components of medical records.

Provide intake for all appeals received.

Proficient in customer service guidelines and standards.

Utilize internal quality control tools to assess individual work and team processes.

High school diploma or equivalent.

Post high school business courses helpful.

Medical terminology desired.

Excellent verbal communication skills, courteous and patient demeanor, must be customer oriented and have the ability to maintain composure under potentially stressful situations.

Good grammar, punctuation, spelling, hyphenation, and written communications skills.

Customer focused, results oriented and capable of building and maintaining relationships with internal and external customers. Must be flexible and able to work as a team member and support team decisions.

General knowledge of a PC based computer system desirable. Knowledge of various software packages with ability to learn additional software packages as needed.

Must be able to multi-task and to prioritize assignments.

Must have good organizational skills and be able to work independently.

Two to three years clerical experience including word processing, various filing systems, and telephone customer service responsibilities.

Prior work in a healthcare setting or medical terminology recommended. Previous data entry or other clerical experience is a plus.

Benefits are a key component of your rewards package. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.