[Remote] Concierge Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. MedWatch, LLC is seeking a Concierge Customer Service Representative to provide excellent customer interaction skills. This role involves responding to customer inquiries, assisting members with benefits and healthcare questions, and documenting all communications.

Responsibilities

• Respond to telephone and email inquiries received from members and provider within defined service standards. Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers
• Assist members with benefits and healthcare questions
• Document all calls received in system-based call log
• The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice

Skills

• Minimum HS Diploma/GED
• One year Customer Service / Call Center experience in a health care related role
• Patience and ability to handle difficult situations tactfully and diplomatically
• Strong customer relations, interpersonal skills
• Strong appreciation and ability to handle confidential & sensitive information
• Proficient with Microsoft applications, strong computer skills and computer navigation
• Excellent data entry and typing skills
• Knowledge of provider organizations and networks
• Knowledge and understanding of CMS Medicare reimbursement rates
• Ability to effectively negotiate rate structures
• Takes initiative to resolve situations and to accomplish projects actions and tasks
• Excellent verbal and written communication skills
• Independent judgment in decision making and problem solving
• Ability to multi-task and anticipate potential needs/problems
• Ability to build relationships with internal and external customers
• Medical Terminology
• Strong attention to detail
• Strong analytical and research skills
• 2 years college or higher education
• Medical Intake or Third-Party Administrator (TPA) experience
• Bilingual English-Spanish
• Understanding of Self-Funded health benefits
• Claim processing skills
• Insurance verification or pre-certification
• Provider office/facility billing department or financial area

Company Overview