Remote Healthcare Customer Service Representative

A-Line Staffing Solutions is recruiting for a remote Care Coordinator role. The coordinator handles patient and provider inquiries, processes referrals and applications, and supports patient accounts through approval or denial while providing empathetic customer service.

Responsibilities:

• Handling inbound and outbound calls to determine needs and provide one call resolution
• Reporting adverse events within the required timeframe
• Creating and completing accurate referrals and applications, and keeping updated on policy or procedural changes
• Investigating and resolving patient/physician inquiries and concerns in a timely manner
• Entering detailed information into company proprietary software while conversing via telephone
• Placing outbound phone calls for patient follow-ups or confirmations
• Demonstrating superior customer support talents
• Interacting with the patient referral sources to process new applicants
• Stewarding patient accounts from initial contact through final approval/denial
• Prioritizing multiple, concurrent assignments, and working with a sense of urgency
• Maintaining quality and providing an empathetic and supportive experience to the patient by controlling the patient conversation, educating the caller as they provide effective and efficient strategies and processes
• Effectively apply knowledge of job and company policies and procedures to complete a variety of assignments
• Demonstrate in-depth knowledge in technical or specialty area
• Apply advanced skills to resolve complex problems independently
• Modify process to resolve situations, as needed
• Work independently within established procedures; may receive general guidance on new assignments
• Provide general guidance or technical assistance to less experienced team members, as needed

Requirements:

• 1-3 years of relevant professional experience, preferably in customer service, with strong knowledge of practices and procedures commonly used in a call center or customer service environment
• Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers
• Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust
• Robust computer literacy skills including data entry and MS Office-based software programs
• A minimum of a High School Diploma or GED
• Clear knowledge of Medicare, Medicaid, and Commercial Payer Policies and guidelines for coverage preferred
• Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices preferred
• Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices preferred
• Fluency in both English and Spanish preferred