AlliedTravelCareers is working with Cynet Health to find a qualified Technician in Bellaire, Texas, 77401!
About The Position
Job Title : Senior Call Center Representative Job Specialty : Member Services - Inbound, Health Plan Job Duration : 14 months Shift : Remote - Must be local in the event there is a need to come into the office Guaranteed Hours : 40 hours per week Experience : Minimum of 3 years in customer service within managed care or insurance industry, or call center experience in any industry License : N / A Certifications : N / A Must-Have : High school diploma or GED, member service experience, bilingual preferred (English / Spanish) Job Description : Serve as a Member and Provider Advocate by understanding organizational processes, policies, and procedures.
- Investigate, resolve, and facilitate resolution of simple to moderately complex issues or questions reported by health plan members, prospective members, healthcare providers, or other entities.
- Be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and other Member / Provider needs.
- Assist and advocate for Members and Providers throughout the complaint and appeal process.- Assist Members with timely appointment scheduling.
- Verify member eligibility and support Call Center Representatives as needed.- Act as a secondary resource to Call Center Representatives in the absence of the Team Lead.
- Respond to escalated calls and triage to Management if necessary.- Assist with processing workflow queues to ensure timely submittal as requested by the Team Lead.
- Help onboard new hire employees in a Nesting environment, providing job shadowing and mentorship.- Complete and manage Pharmacy queue and Right Fax.
- Assist members / providers with billing inquiries and resolve billing issues. Skills Required : Knowledge of managed care, Medicaid, call center desktop support applications, customer relations techniques, and general computer literacy.
- Benefits, claims processing, or membership knowledge preferred.- Ability to work well with the public, adopt a customer perspective, and excel individually and in a team environment.
- Effective interpersonal skills and phone etiquette.- Strong verbal communication and good listening skills.- Knowledge of medical terminology.
- Problem identification and solving skills, with the ability to multitask.- Typing skills, 35 WPM.- Bilingual in English and Spanish is preferred.
9456965EXPPLAT
Job Requirements
Required for Onboarding
- BLS - AHA
- Pharmacology
- Skills Checklist
- Specialty Exam
About Cynet Health
Your travel adventure begins here. Matching talented healthcare heroes like you with high-paying jobs at the best facilities across all 50 states.
We offer the most competitive pay for every position we fill. We understand this is a partnership. You will have no surprises.
Your salary will be discussed upfront and there will be no troubling negotiation tactics.
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