Provider Customer Service Representative
Description:
? Answers questions and resolves issues based on phone calls/letters from providers.
? Provide excellent customer services for high volume inbound provider calls.
? Extensive claims research on multiple platforms.
? Uses customer service threshold framework to make financial decisions.
? Processes claim referrals, new claim handoffs, nurse reviews, and provider complaints.
? Educates & assists providers on our self-service options.
? Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility.
? Performs review of member and provider claim history.
Requirements: ? Familiarity with Microsoft Office products ? Excellent computer skills using multiple screens and systems ? Experience in highly transactional call center environment ? Excellent customer service and critical thinking ? Secure, private home office location ? High speed internet access (100 mbps or higher)
Benefits:
? Full range of medical, dental, and vision benefits
? 401(k) retirement savings plan
? Employee Stock Purchase Plan
? Fully-paid term life insurance
? Short-term and long-term disability benefits
? Well-being programs
? Education assistance
? Free development courses
? CVS store discount
? Paid Time Off (PTO)
? Paid holidays
Similar Remote Jobs
Provider Customer Service Representative
Posted on: 27-02-2025 00:00
Remote Customer Service Representative
Posted on: 27-02-2025 00:00
Administrative Assistant/Data Entry Clerk
Posted on: 27-02-2025 00:00
Remote Jobs for Students
Posted on: 27-02-2025 00:00
Online Chat Support Representative
Posted on: 27-02-2025 00:00
Remote - Business Development
Posted on: 27-02-2025 00:00
Text Collector (Project Nimbus)
Posted on: 27-02-2025 00:00
Fully Remote Sales Specialist
Posted on: 27-02-2025 00:00
Remote Front Desk Attendant
Posted on: 27-02-2025 00:00
iOS Developer Retail Engineering
Posted on: 27-02-2025 00:00
(Remote Part-time jobs) Fedex Data Entry Remote Jobs ? WFH
Posted on: 05-07-2024 05:50
Sales Professional For Work From Home With Flexible Hours
Posted on: 27-02-2025 00:00
Central Selling Associate - Millwork - REMOTE - PST, MST & CST Only
Posted on: 26-12-2024 06:12
Customer Support & Sales Representative (Inbound Calls & Chat Support) - Contract to Hire
Posted on: 18-09-2024 00:00
UHOne Sales Enablement Co-op - Remote
Posted on: 29-10-2024 05:42
Forklift Material Handler
Posted on: 02-02-2025 00:00
PT CUSTOMER EXPERIENCE SPEC I
Posted on: 18-09-2024 00:00
Freelance Writing Blog | $25-$35/hr | No Experience, Start Now
Posted on: 16-07-2024 18:49
(Remote) - Entry-Level Account Manager (20 - 27 per hour)
Posted on: 09-11-2024 04:38
Pharmacy Care Technician - Remote in EST or CST
Posted on: 26-09-2024 00:00