Customer Service Representative
12 south Street, Westborough, MA 01581 Westborough, MA
Your responsibilities includes:
• Answers incoming calls received through the toll free Pre-Authorization Support ACD and provide appropriate call/case handling.
• Performs initial benefit verification and pre-surgical authorization for new pre-surgical cases by working closely with all payers
• Documents case status, actions, and outcome in the Pre-Authorization Support contact management database utilizing who, what, where, when, how
• Communicates and builds relationships with HCP offices and sales representatives in regards to all inquiries for the handling of cases, i.e., missing case information, benefits etc.
• Responsible for notifying the appropriate internal departments based on receipt of information that department needs to be aware of including complaint handling/ adverse event notifications
• Utilizes customer service skills in engaging with customers, communications with Sales representatives, and working in teams in a call center environment to expedite processing of cases.
List required Education/Experience/Skills a candidate must have to successfully perform the above duties/tasks:
• High School diploma or Equivalent
• 1+ year's experience in Insurance Reimbursement, Customer Service, or Medical device industry is require
• Must be able to understand the complexities of the Insurance Reimbursement work flow and related processes. .
• Must have basic understanding of Medicare, Medicaid, Private Payer, and Workers compensation coding, coverage, and payment as it relates to medical procedures, services, and devices
• Must possess strong computer skills and have working knowledge of Microsoft outlook, Microsoft Word and Excel. Must be able to type minimum of 45 wpm
• Must have exceptional organizational skills and a keen attention to detail, and be multi-task oriented
• Must demonstrate ability to effectively build relationships and communicate with both internal and external customers
• Must be able to accurately document and verbalize issues and have the ability to work with in a team environment and across departments
List Education/Experience/Skills that are not required, but helpful:
• Must be able to work in an environment where meeting and executing on timelines is essential. MUST be a team player
• Must be able to work in a fast pace environment in which information is constantly changing; must be able to embrace changes
• College undergraduate degree strongly preferred. Some college preferred.
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