REMOTE Healthcare Customer Solutions Expert - Sleep Management

 

Overview:

In this role, you will identify the need(s) of the referring source and/or patient by collecting all necessary data relevant to that need; interpret, verify and process that data to determine if patient is eligible; and facilitate the initiation and termination of the care and services provided in a timely manner. Respond to customer issues that may arise during and after order processing. Actively engages and coordinates with other team members to maintain a positive, collaborative relationship. Works under close supervision.

Responsibilities:

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In this role you will:

• Work closely with health plans/payers and maintains strong business relationships.
• Provide appropriate issue resolution and/or escalation when needed. Work under moderate supervision, with clinical oversight.
• Participate in and contribute to performance improvement activities.
• Learn, understand and maintain working knowledge of products and services offered by the company.
• Receive and respond to incoming calls or faxes from providers, referral sources, and potential patients.
• Communicate with carrier/health plan representatives, providers, and patients.
• Provides issue resolution and escalation to management when appropriate.
• Document all communications and decisions into a computer database.
• Understand and evaluate patient PAP adherence reports and other mechanisms of therapy.
• Consult applicable Payer Fact Sheets and other available resoureces. Works with other staff and patients to identify potential solutions as problems are identified.
• Assure the completion and coordination of work in an associate’s absence, or as needed, to maintain departmental standards.
• Follow up with servicing providers to ensure authorization to completion as well as ensures timely delivery of services.
• Master the Intake/Verifications function as a second function; Staffing as back-up and learn two health plans.
• Participates in special projects and performs other duties as assigned.

Qualifications:

You should reach out if you have:

• A High School Diploma or the equivalent.
• Minimum 1 year work experience in a customer service environment.
• 1 year billing, insurance or claims experience preferred.
• Experience with Medical terminology, insurance verification or healthcare experience preferred.
• Proficiency and are comfortable in a computer-based environment.
• Values of accountability, consistency, engagement, patient compassion, empowerment, respect and outstanding service.
• Excellent communication, customer service and problem solving skills, as well as the ability to effectively interact with all levels of management and highly diverse customers.

What we offer:

• Starting Pay for external hires is $17.50/hr + Monthly Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
• Profit Sharing, generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
• Advancement opportunities, professional skills training, and tuition Reimbursement
• Great culture with a sense of community.

CareCentrix maintains a drug-free workplace.

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We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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