Communication Center Representative

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Location: Remote within US ONLY

Required Schedule: Monday - Friday, 11:00 AM EST - 8:00 PM EST or Wednesday - Sunday, 11:00 AM - 8:00 PM EST (we have two openings and cannot guarantee preferred schedule)

Position Summary:

The WISeR Communication Center Representative serves as the primary point of contact for providers, facilities, and internal partners seeking support with WISeR workflows. This role is responsible for delivering timely, professional, and empathetic customer service while assisting with prior authorization requests, case status inquiries, documentation intake, and portal navigation.

The ideal candidate is detail‑oriented, calm under pressure, and committed to creating a positive customer experience while supporting compliance‑driven healthcare processes.

Key Responsibilities:

Customer Support & Communication

• Respond to inbound inquiries via phone, email, portal, and fax regarding WISeR cases and prior authorization requests.
• Provide clear, courteous updates on case status, next steps, and estimated turnaround times.
• Educate customers on submission options (portal, fax, alternate workflows) to help prevent delays in patient care.
• De‑escalate concerns professionally and route issues appropriately when escalation is needed.

Case & Workflow Support

• Review incoming requests for completeness and accuracy.
• Assist with documentation intake and routing to the appropriate WISeR queue.
• Identify submission issues related to NPI, PTAN, UTN, or enrollment details and communicate corrective guidance.
• Document all customer interactions accurately in internal systems.

Operational Coordination

• Collaborate with WISeR clinical, admin, and management teams to support timely case resolution.
• Escalate cases following established escalation guidelines when SLA or impact criteria are met.
• Track follow‑ups and ensure customers receive consistent and accurate information.

Quality & Compliance

• Adhere to HIPAA and data privacy requirements when handling PHI and sensitive information.
• Follow internal policies and standard operating procedures (SOPs).
• Contribute to continuous improvement by identifying recurring issues and suggesting process enhancements.
• Support maintenance of knowledge base articles and customer guidance materials.

Required Qualifications

• High school diploma or equivalent required (Associate’s or Bachelor’s degree preferred).
• 1–3 years of customer service experience, preferably in healthcare, insurance, or revenue cycle environments.
• Strong verbal and written communication skills.
• Ability to manage multiple tasks in a fast‑paced, metrics‑driven environment.
• High attention to detail and documentation accuracy.
• Comfort working with portals, case management systems, and Microsoft Office tools.

Preferred Qualifications

• Experience with prior authorization, utilization management, or medical review workflows.
• Familiarity with Medicare Part A / Part B concepts.
• Experience supporting providers or facilities in a healthcare operations setting.
• Knowledge of HIPAA and handling of PHI.

Key Competencies

• Exceptional customer service and empathy
• Professional written and verbal communication
• Problem‑solving and critical thinking
• Time management and organization
• Compliance awareness
• Team collaboration

Success Metrics

• Customer satisfaction and response quality
• Adherence to turnaround time standards
• Accuracy of case documentation and routing
• Appropriate escalation and follow‑through
• Positive feedback from internal and external partners

Work Environment

• Remote
• Healthcare operations setting with structured workflows
• Regular collaboration with clinical and operational teams

• Competitive hourly salary
• Medical/Dental/Vision Insurance
• Equipment provided
• 401k matching (up to 2%)
• PTO: 80 hours accrued, annually
• 9 paid holidays
• Tuition reimbursement
• Professional growth and more!

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.