Experienced Customer Service Specialist - Remote Opportunity at careerzynith
Job Title: Experienced Customer Service Specialist - Remote Opportunity at careerzynith
Job Description:
About careerzynith
At careerzynith, we are dedicated to providing exceptional customer service and empowering patients to live their best lives. As a leading provider of full-service home medical equipment products and services, we strive to make a profound impact on the quality of patients' lives. Our team is passionate about delivering outstanding care and support to our patients, and we are seeking a skilled Customer Service Specialist to join our remote team.Job Summary
As a Customer Service Specialist at careerzynith, you will be responsible for providing exceptional customer service to our patients, answering inbound calls, and making outbound calls to ensure successful service delivery. You will work in a fast-paced environment, developing and maintaining a working knowledge of our products and services, and utilizing your analytical and problem-solving skills to resolve customer complaints and issues.Key Responsibilities
- Develop and maintain working knowledge of current products and services offered by careerzynith
- Answer all calls and emails in a timely manner, in adherence to our goals and standards
- Document all call information according to standard operating procedures
- Answer questions about products and services, retail stores, general service line information, and other information as necessary based on customer call needs
- Process orders, route calls to appropriate resources, and follow up on customer calls where necessary
- Review all required documentation to ensure accuracy
- Accurately process, verify, and/or submit documentation and orders
- Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles
- Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required
- Must be able to navigate through multiple online EMR systems to obtain applicable documentation
- Enter and review all pertinent information in EMR system, including authorizations and expiration dates
- Communicate with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies
- Verify insurance carriers are listed in our database system, if not, request the new carrier is entered
- Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process
- Meet quality assurance requirements and other key performance metrics
- Facilitate resolution on customer complaints and problem-solving
- Pays attention to detail and has great organizational skills
- Actively listens to patients and handles stressful situations with compassion and empathy
- Flexible with the actual work and the hours of operation
- Utilize company-provided tools to maintain quality, including but not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System), and "How-To" documents
Competency, Skills, and Abilities
- Excellent customer service skills
- Analytical and problem-solving skills with attention to detail
- Decision-making
- Excellent ability to communicate both verbally and in writing
- Ability to prioritize and manage multiple tasks
- Proficient computer skills and knowledge of Microsoft Office
- Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
- Work well independently and as part of a group
- Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative, and work effectively on a team
Requirements
- Minimum Job Qualifications:
- High School Diploma or equivalent
- One (1) year work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management, regardless of industry
- Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
- Exact job experience is considered any of the above tasks in a Medicare-certified