Customer Service Rep I

Scalence L.L.C. is seeking a Customer Service Representative to manage inquiries and support for internal and external customers. The role involves handling authorization status, maintaining patient account information, and participating in team initiatives to improve service quality.

Responsibilities:

• Manage Program wide fax number and distribute faxes to appropriate team members by uploading into program software
• Answer program 800 phone line
• Provides support for inquiries from internal and external customers regarding account/authorization status. Maintains updated information on patient accounts
• Handles internal and external customer inquiries regarding authorization status and insurance verification history
• Actively participates in team initiatives and in team status meetings; Additional team activities, projects, and workflow as assigned
• Actively participates in process and service improvement activities
• Encourages and supports staff members in the pursuit of service excellence
• Develops understanding of Client therapies within pain interventions space
• Performs eligibility verifications on patient accounts as new insurance plans/carriers are identified; updates information on expired insurance plans/carriers
• Meets or exceeds key performance indicators measuring productivity, quality and service level as defined by Senior Management
• Research issues off-line as needed with payor/physicians/ patient; conducts follow-up calls with customers, initiating conference calls between insurance carrier and patients to resolve customer concerns
• Initiates follow-up activities regarding open authorizations and makes written and verbal inquiries to payors. Analyzes and problem-solves account issues to full resolution
• Answers all calls and inquiries with professionalism and seeks to have “one call resolution.”

Requirements:

• Manage Program wide fax number and distribute faxes to appropriate team members by uploading into program software
• Answer program 800 phone line
• Provides support for inquiries from internal and external customers regarding account/authorization status
• Maintains updated information on patient accounts
• Handles internal and external customer inquiries regarding authorization status and insurance verification history
• Actively participates in team initiatives and in team status meetings; Additional team activities, projects, and workflow as assigned
• Actively participates in process and service improvement activities
• Encourages and supports staff members in the pursuit of service excellence
• Develops understanding of Client therapies within pain interventions space
• Performs eligibility verifications on patient accounts as new insurance plans/carriers are identified; updates information on expired insurance plans/carriers
• Meets or exceeds key performance indicators measuring productivity, quality and service level as defined by Senior Management
• Research issues off-line as needed with payor/physicians/ patient; conducts follow-up calls with customers, initiating conference calls between insurance carrier and patients to resolve customer concerns
• Initiates follow-up activities regarding open authorizations and makes written and verbal inquiries to payors
• Analyzes and problem-solves account issues to full resolution
• Answers all calls and inquiries with professionalism and seeks to have 'one call resolution.'