Handling Receipt of New Cases:
Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS.
Work with client on any information missing pertinent to processing claim.
Sort, organize and create medical document listing
if required by client, and in line with specific special handling.
Oversight of Cases:
Monitor, process and track cases to ensure we meet deadlines.
Assignment of Cases:
Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
Ensure that the assigned physician has no conflict of interest with the case assignments
Client Interaction:
Update clients frequently on cases in progress.
May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
Ensure proper documentation for specified cases is provided to the client.

A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required.
Experience working in a healthcare (medical office, insurance claims, etc.) environment preferred.
Excellent computer skills (Apple Operating System, Google Chrome search engine, Gmail are preferred).
Stellar written and verbal communication skills, including a high comfort level in speaking with the referring client, claimants, and/or physician.
Ability to maintain focus and attention to detail in a fast-paced environment.
Ability to manage multiple tasks and quickly changing priorities.
Excellent organizational skills.

medical, dental, and vision coverage for you and your family
voluntary life insurance options for you, your spouse, and your children
other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans
basic life insurance, short-term disability, and long-term disability coverage at no cost
generous paid time off policy
401k plan with a company match
Apple equipment and a media stipend for remote workspace

Group Health Customer Service Representative

Key skills