Disability Customer Service Representative

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 and scheduling process.

Responsibilities:

• Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS
• Work with the client on any information missing pertinent to processing the claim
• Sort, organize and create a medical document listing - if required by the client, and in line with specific special handling
• Monitor, process and track cases to ensure we meet deadlines
• 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
• 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:

• 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 the client on any information missing pertinent to processing the claim
• Sort, organize and create a medical document listing - if required by the 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
• Good communication skills with a clear understanding of company business lines
• The ability to apply critical thinking, manage time efficiently and meet specific deadlines
• Computer literacy and typing skills are essential
• An Associate's Degree preferred
• Business experience in a healthcare and/or insurance setting is preferred