Medicare Appeals Customer Service Specialist

Description

Join our organization where we're dedicated to enhancing health outcomes through innovative technology, expert services, and clinical excellence. Our mission is to create health solutions that offer maximum value and impact, and we welcome you to be a part of a dynamic team focused on problem-solving and ownership.

In this remote role, you will be crucial in supporting the Medicare Appeal process. Your responsibilities will include managing incoming calls, addressing customer inquiries, resolving complaints, and adhering to internal policies and procedures. Your knowledge of our services will be vital in meeting productivity and quality standards effectively.

Key Responsibilities

• Knowledge and Communication: Understand our internal policies, procedures, and services. Utilize automated systems to log and retrieve information while performing accurate data entry of electronic faxes.
• Customer Interaction: Handle inquiries from customers or providers via telephone, email, fax, or mail, ensuring timely responses. Address telephone inquiries and complaints promptly and courteously, following standard protocols.
• Problem Solving: Investigate and resolve customer issues or escalate when necessary. Identify and report challenging situations to the appropriate parties.
• Documentation: Collect and enter demographic, provider, and procedure information to initiate files. Maintain logs and document the details of incoming and outgoing calls.
• Liaison Role: Act as a liaison between Review Supervisors and external providers.
  
  

Why You'll Love Working Here

Our team consists of dedicated leaders, clinicians, technologists, and industry professionals who are enthusiastic about redefining healthcare expectations. You will engage in meaningful work that positively impacts lives across the nation. We value our employees and provide the tools and support necessary for you to achieve your best work.

Requirements

• High School diploma or equivalent.
• 2+ years of customer service or telephone experience, preferably in a call center environment.
  
  

Preferred Qualifications

• Experience in a medical office or similar medical setting.
• Knowledge of eligibility verification (e.g., Medicaid) and program requirements.
• Familiarity with CPT and HCPCS codes.
  
  

Benefits

We offer a comprehensive benefits package designed to support your career and well-being, including health plans, paid time off, retirement savings, wellness programs, educational assistance, and corporate discounts.

Equal Opportunity Employer

We are an Equal Opportunity Employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law.

Employment Type: Full-Time