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Customer Service Representative (Remote)

Acentra Health • Remote • Posted 7 days ago

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Remote • Full-time • $15.85-$18.20/hr • Entry Level

Job Highlights

Using AI ⚡ to summarize the original job post

The Customer Service Representative at Acentra Health is responsible for supporting the Medicare Appeal process by handling incoming calls, resolving customer inquiries, complaints, and requests in accordance with internal policies and procedures. This role involves utilizing automated systems for data entry, interacting with hospitals, physicians, and beneficiaries, and serving as a liaison between Review Supervisors and external providers. The position is remote and offers opportunities for career advancement and better health outcomes.

Responsibilities

  • Develops and maintains working knowledge of internal policies, procedures, and services.
  • Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes.
  • Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times.
  • Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures.
  • Interacts with hospitals, physicians, beneficiaries, or other program recipients.
  • Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party.
  • Meets or exceeds standards for call volume and service level per department guidelines.
  • Initiates files by collecting and entering demographic, provider, and procedure information into the system.
  • Serves as liaison between the Review Supervisors and external providers.
  • Maintains logs and documents disposition of incoming and outgoing calls.

Qualifications

Required

  • High School diploma or equivalent
  • 2+ years' customer service/telephone experience in a similar call center environment and/or industry.
  • Ability to effectively communicate with team members and external customers
  • Ability to research and resolve issues related to Medicaid program and service eligibility
  • Bilingual (Spanish/English)

Preferred

  • Previous experience in the medical office or other medical setting
  • General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus)
  • Knowledge of CPT and HCPCS codes
  • PC proficiency to include Microsoft Office Suite
  • Experience with Microsoft programs

About Acentra Health

Acentra Health is a leading company in the healthcare industry. They offer advanced systems and solutions that focus on technological innovation, clinical expertise, and public sector health knowledge to improve the healthcare experience for priority populations. Their comprehensive range of solutions includes advanced processing solutions, clinical services, data analytics, and provider solutions aimed at delivering maximum value and impact to government healthcare programs.

Full Job Description

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company's mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Customer Service Representative to join our growing team.

Job Summary:

The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization's services to meet productivity and quality standards.

*This position is remote*

Job Responsibilities:
    • Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)
    • Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes
    • Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
    • Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
    • Interacts with hospitals, physicians, beneficiaries, or other program recipients
    • Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party
    • Meets or exceeds standards for call volume and service level per department guidelines
    • Initiates files by collecting and entering demographic, provider, and procedure information into the system
    • Serves as liaison between the Review Supervisors and external providers
    • Maintains logs and documents disposition of incoming and outgoing calls

Requirements
    • High School diploma or equivalent
    • 2+ year's customer service/telephone experience in a similar call center environment and/or industry.
    • Must have ability to effectively communicate with team members and external customers
    • Must have ability to research and resolve issues related to Medicaid program and service eligibility
    • Bilingual (Spanish/English)

Preferred Qualifications/Experience:
    • Previous experience in the medical office or other medical setting preferred
    • General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
    • Knowledge of CPT and HCPCS codes preferred
    • PC proficiency to include Microsoft Office Suite
    • Experience with Microsoft programs

Benefits

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with 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.

Compensation

The pay range for this position is $15.85 - $18.20

"Based on our compensation program, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration 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 Federal, State or Local law.