Customer Service Rep

Industry

Call Center and Customer Service

Advert ID

USA_531796

Location

Houston

Job Type

Contract

Hours

Full-Time

Salary Range

Up to USD15.00/hr

No. of Openings

1

Branch Information

Houston, TX - Metro - (USA) 10235 West Little York Road Suite 159 TX Houston , TX 77040 Phone : 713-386-1416

ContactNumber

713-386-1416

Job Description

Call Center / Customer Service - Customer Service Rep 1



Shift Schedule: 08:00:AM-05:00:PM [Lunch: 12:00:PM-01:00:PM]

Job Description

Verifies insurance benefits for new patient referrals and re-verifies existing patient benefits as indicated by policy. Obtains pre-certifications, pre-determinations, and authorizations for services per insurance guidelines. Evaluates profitability of therapies and communicates issues.



Essential Functions and Duties

o Manage work queue to department standards for productivity and quality.

o Verifies insurance benefits for new patient referrals.

o Re-verifies insurance benefits for existing patients.

o Accurately evaluates charge and reimbursement estimates for infusion therapies.

o Reviews all medical documentation against medical policy and initiates/obtains pre-determination, pre-certification, and authorizations as needed.

o Follow-up on pending pre-certifications and/or pre-determinations until outcome decided.

o Updates and maintains insurance and authorization information in billing software.

o Obtains PCP referrals as needed.

o Completes special projects as assigned.

o Performs other job-related duties as assigned.



Minimum Requirements

o Two or more years of related experience in a healthcare industry, preferably intake/patient access experience.



Critical Skills

o Must be able to communicate effectively, both orally and in writing.

o Must demonstrate an understanding of reimbursement practices including government program regulation and managed care contracting

o Experience working in, and managing changing priorities, in a high volume, fast-paced work environment.

Excellent personal computing skills and a working knowledge of MS Office software

o Maintains clear communication with customers regarding mutual expectations. Takes personal responsibility and accountability for correcting customer- service problems.



Additional Knowledge and Skills

o Ability to work well as part of a collaborative team as well as independently.



Education

o High School diploma or equivalent



Physical Requirements

o Professional office environment



Remote Opportunity must be local to Houston area