Group Health Customer Service Representative

Dane Street is a fast-paced, Inc. 500 Company that processes over 200,000 insurance claims annually. They are seeking a Customer Service Representative to manage client interactions, schedule reviewers, and ensure the timely processing of cases within their network.

Responsibilities:

• 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

Requirements:

• A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required
• 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
• Experience working in a healthcare (medical office, insurance claims, etc.) environment preferred
• An Associate's Degree is preferred