Customer Service Representative/Review Assistant (hybrid)

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise.

Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily.

Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Customer Service Representative / Review Assistant to join our growing team.

Job Summary :

The Customer Service Representative / Review Assistant plays a crucial role in supporting our review process by answering incoming calls and resolving customer inquiries while adhering to company policies and procedures.

This position involves preparing prior authorization cases for clinical review, ensuring smooth operations, and maintaining high productivity and quality standards.

The role includes preparing necessary documentation, managing mailings, and compiling reports to meet eligibility, service, and hearing requirements.

By ensuring the delivery of accurate and timely services, you will contribute significantly to the success of the organization’s mission.

Position is hybrid. Candidates are expected to be able to travel to the Charleston, WV office once a week. Candidates living within 30 miles of Charleston are preferred.

Job Responsibilities :

• Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational).
• Receive inquiries by telephone, email, fax, or mail and communicates response within required turnaround times.
• Respond to telephone inquiries in a prompt, accurate, and courteous manner following standard operating procedures.
• Serve as liaison between the internal and external partners.
• Investigate and resolve or report provider problems, and identify and escalate difficult situations to the appropriate party.
• Meet or exceed standards for call volume and service level per department guidelines.
• May be responsible for the completion of daily, monthly, and quarterly reports necessary for the clinical team operations and client reporting.
• Ensure the accurate and timely submission of all administrative documents to the relevant parties, maintaining the highest standards of administrative support.
• Take an active role in attending training sessions and meetings. You will be responsible for maintaining and utilizing current and updated information for case preparation, ensuring the highest level of proficiency and knowledge.
• Be prepared to undertake other tasks as assigned. This list of responsibilities is dynamic and may be broadened to encompass other duties related to education and experience that management considers essential.

Requirements

Required Qualifications / Experience :

• Requires a High School diploma or equivalent.
• Requires a minimum of two years of customer service experience.

Preferred Qualifications / Experience :

• Proficiency in Microsoft Word and Outlook, along with the ability to learn and use proprietary software effectively.
• Medical terminology course(s).
• Knowledge of the health insurance industry
• Effective verbal and listening skills to provide courteous and professional customer service.
• Capable of interpreting complex documentation and organizing and presenting case information with clarity and accuracy.
• Demonstrated ability to function effectively within a team environment and independently.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry.

State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted.

We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you.

Best of luck in your search!

The Acentra Health Talent Acquisition Team

Visit us at Acentra.com / careers /

EOE AA M / F / Vet / Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work.

Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is $15.83-16.83.

Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.