Dane StreetRemote
Government Customer Service Representative
United States
Full Time
3 hours ago
H1B Sponsor
Key skills
Healthcare claimsbillingConflict resolutionExceptional communicationCritical thinkingTime managementCustomer excellenceComputer literacyTyping skillsCustomer focusProblem-solvingProfessionalismIntegrityLeadershipCommunicationCritical ThinkingTime Management
About this role
Dane Street is a fast-paced, Inc. 500 Company that processes over 200,000 insurance claims annually. The Customer Service Representative is responsible for the receipt of new cases, ensuring proper system drafting and setup, and facilitating the case assignment/scheduling process.
Responsibilities:
- Intake new cases and review/verify information and requests
- Draft cases by entering information into the Dane Street systems
- Work with the client on any missing information pertinent to processing the claim
- Sort, organize, and create a medical document listing, if required by the client, in line with specific special handling
- Respond to inbound calls, emails, and portal inquiries
- Maintain efficient and accurate records related to all client interactions
- Ensure compliance with Federal NSA regulations, processes, and policies
- Collaborate with the Leadership team and other departments to ensure timely resolutions
- Ability to process and interpret reporting
- Adhere to or exceed metrics/goals
- 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 assignment
- Monitor, process, and track cases to ensure we meet deadlines
- 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
- Maintain consistent professionalism at all times
- Other duties & special projects, as assigned and based on business needs
Requirements:
- An Associate's Degree is preferred
- Business experience in a healthcare and/or insurance setting is preferred
- Healthcare claims and billing
- Conflict resolution and de-escalation skills
- Present exceptional communication skills with a clear understanding of the company's business lines
- The ability to apply critical thinking, manage time efficiently, and meet specific deadlines
- Computer literacy and typing skills are essential
- Customer focus, problem-solving, professionalism, integrity, customer excellence, and time management