Call Center Customer Service Representative

The HIRD- USA is seeking a Call Center Customer Service Representative. This role involves answering incoming phone calls from healthcare providers and members, providing assistance with benefits, authorizations, and resource identification.

Responsibilities:

• Focus on one call resolution, navigating through complex computer systems to identify the status of the request and provide appropriate response to caller
• Deliver information and answer questions in a confident manner to facilitate positive outcomes with the providers and members we serve
• Complete thorough documentation of call interactions with real time talking and typing
• Serve as a resource or Subject Matter Expert for team members or internal customers
• Make outbound calls to families who have a child with Autism to discuss provider referrals and behavioral health needs
• Data collection from providers, inputting information into multiple documentation systems
• Contact providers to clarify information, review benefits and authorizations, and assist with care coordination
• Coordinate information to clinical team partners
• Triage submission of clinical information, set up cases to improve timely review, and complete administrative follow-ups on cases

Requirements:

• High School Diploma/ GED or higher
• 2 years of healthcare experience
• 2 years of call center experience
• 1 year of work from home experience
• Internet speed of 30 mbps download and upload
• Experience working within a medical/behavioral setting (e.g. hospital, managed care organization, or joint medical/behavioral outpatient practice)
• Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
• Working knowledge of community-based resources and services