Customer Solutions Expert I – Client Services Team
Job Locations: Remote
Job ID: 2019-6871
Identify the need(s) of the referring source and/or patient by collecting all necessary data relevant to that need; interpret, verify and process that data to determine if patient is eligible; and facilitate the initiation and termination of the care and services provided in a timely manner. Respond to customer issues that may arise during and after order processing. Actively engages and coordinates with other team members to maintain a positive, collaborative relationship. Works under close supervision.
- Works closely with health plans/payers and maintains strong business relationships.
- Provides appropriate issue resolution and/or escalation when needed. Works under moderate supervision, with clinical oversight.
- Reviews and adheres to all Company policies and procedures and the Employee Handbook.
- Participates in special projects and performs other duties as assigned.
- Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills.
- Manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking.
- Participates in and contributes to performance improvement activities.
- Learn, understand and maintain working knowledge of products and services offered by the company.
- Accurate and complete data collection from referrals and completion of applicable paperwork. Interpret, verify and accurately enter data into computer to process orders.
- Answers telephone calls in a professional, friendly, helpful manner.
- Ensure patient qualifies for the type and quantity of product(s) ordered, based upon the patient’s insurance and/or SMS contract guidelines.
- Obtain insurance authorization, when necessary.
- Promptly respond to and resolve customer issues.
- Requires a HS diploma or equivalent; up to 1 year of previous related experience; or any combination of education and experience, which would provide an equivalent background.
- One year billing, insurance or claims experience preferred.
- The ability to effectively multi-task.
- Medical terminology, insurance verification or healthcare experience preferred.
- Must be proficient and comfortable in a computer-based environment.
- Embraces the values of accountability, consistency, engagement, patient compassion, empowerment, respect and outstanding service.
- This position requires excellent communication, customer service and problem-solving skills, as well as the ability to effectively interact with all levels of management and highly diverse customers.
- Must have strong organizational skills and be extremely detail-oriented.
- Demonstrates critical thinking and has the ability to analyze data to understand an expected outcome, Must be able to effectively manage and prioritize tasks and thrive in a fast-paced environment.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill and/or ability required.
- Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Masters the Intake/Verifications function as well as a second function; Staffing as back-up and learns two health plans.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.