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REMOTE Healthcare Customer Solutions Expert - Sleep Management


 
Overview:
In this role, you will 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.
Responsibilities:

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In this role you will:
  • Work closely with health plans/payers and maintains strong business relationships.
  • Provide appropriate issue resolution and/or escalation when needed. Work under moderate supervision, with clinical oversight.
  • Participate in and contribute to performance improvement activities.
  • Learn, understand and maintain working knowledge of products and services offered by the company.
  • Receive and respond to incoming calls or faxes from providers, referral sources, and potential patients.
  • Communicate with carrier/health plan representatives, providers, and patients.
  • Provides issue resolution and escalation to management when appropriate.
  • Document all communications and decisions into a computer database.
  • Understand and evaluate patient PAP adherence reports and other mechanisms of therapy.
  • Consult applicable Payer Fact Sheets and other available resoureces. Works with other staff and patients to identify potential solutions as problems are identified.
  • Assure the completion and coordination of work in an associate’s absence, or as needed, to maintain departmental standards.
  • Follow up with servicing providers to ensure authorization to completion as well as ensures timely delivery of services.
  • Master the Intake/Verifications function as a second function; Staffing as back-up and learn two health plans.
  • Participates in special projects and performs other duties as assigned.
Qualifications:
You should reach out if you have:
  • A High School Diploma or the equivalent.
  • Minimum 1 year work experience in a customer service environment.
  • 1 year billing, insurance or claims experience preferred.
  • Experience with Medical terminology, insurance verification or healthcare experience preferred.
  • Proficiency and are comfortable in a computer-based environment.
  • Values of accountability, consistency, engagement, patient compassion, empowerment, respect and outstanding service.
  • 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.

What we offer:
  • Starting Pay for external hires is $17.50/hr + Monthly Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
  • Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
  • Profit Sharing, generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
  • Advancement opportunities, professional skills training, and tuition Reimbursement
  • Great culture with a sense of community.
CareCentrix maintains a drug-free workplace.

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We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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