Customer Services Representative
Insight GlobalMiami, FL, USjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionNavigates multiple systems to obtain the necessary data to issue GOPs Verify payments and / or denials, as well as treatment authorization status, and inform the proper party accordingly Able to be a part of an on-call / duties rotating schedule (after regular office hours and weekends) Bilingual / English and French required 2+ years of experience in customer service, health insurance field a plus High school diploma / GED required Strong analytical, detail-oriented, and accuracy skills are required Ability to manage time effectively, set priorities, meet deadlines, and adapt to change Desire to work in a small entrepreneurial environment
Job Description
Job Description
Job Overview : The role requires communication among medical providers, our client, and members. The customer service rep is to coordinate treatment and provide authorizations / issue GOPs for members in Latin America, Europe, etc. Respond to inquiries about authorizations and documentation requirements.
Responsibilities and Duties :
- Coordinate and determine approvals, eligibility, and inform the medical providers, as well as issue GOPs according to policy and client authorizations
- Tracking and follow-up of all cases, ensuring appropriate follow-up with the medical providers
- Provide guidance, support, and advice to international members seeking medical treatments or procedures
- Responds to routine phone inquiries and written correspondence related to authorizations and claims status
Screens and routes complex cases to the appropriate manager
Qualifications :
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Customer Service Representative • Miami, FL, US
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