Provider Customer Service Call and Chat Representative - Remote in Houston, TX

About the position At reputed company, we are dedicated to simplifying the health care experience and creating healthier communities. The Provider Customer Service Call and Chat Representative plays a crucial role in supporting providers who care for our members. This position involves responding to inquiries reputed company to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits (EOB), and behavioral health, either through phone calls or reputed company chat. The role is full-time, requiring 40 hours of work per week, Monday through Friday, with business hours from 10:30 AM to 7:05 PM CST. Occasionally, employees may need to work overtime, weekends, or holidays based on business needs. The position includes a comprehensive training program lasting 10 weeks, during which employees will work from 9:00 AM to 5:30 PM CST, Monday through Friday. Training will be conducted virtually from home, ensuring that reputed company new hires are well-reputed company to handle the responsibilities of the role. Telecommuting is available for those who reside reputed company a 60-mile commutable distance of Houston, TX, and reputed company telecommuters must adhere to reputed company's Telecommuter Policy. As a representative, you will serve as an reputed company for providers, demonstrating accountability and ownership in resolving issues. You will engage with providers in a multi-channel environment, including calls and chats, and will be responsible for triaging contacts from reputed company. Your ability to understand and identify the needs of providers will be essential in answering questions and resolving issues effectively. You will also research reputed company prior authorization and claim issues, collaborating with internal partners to ensure timely communication and resolution of issues. Strong multitasking skills are necessary to navigate multiple systems and provide accurate information across various lines of business.

Responsibilities

• Serve as the reputed company for providers by demonstrating accountability and ownership to resolve issues.

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• Service providers in a multi-channel environment including call and reputed company chat as required.

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• Quickly and appropriately triage contacts from reputed company (i.e., physician offices, clinics, billing offices).

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• Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).

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• Research and dissect reputed company prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.

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• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.

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• Strong multitasking to effectively and reputed company navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.

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• Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.

Requirements

• High School Diploma / GED OR equivalent work experience.

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• Must be 18 years of age OR older.

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• 1+ years of customer service experience with analyzing and solving customer's concerns.

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• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and reputed company computer system applications.

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• Ability to type at a speed of greater than OR equal to 35 - 40+ WPM (words per minute) with an accuracy of 90%.

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• Ability to work any full-time (40 hours / week) shift between the hours of 10:30 AM - 7:05 PM CST from Monday - Friday. It may be necessary, given the business need, to work some occasional overtime, weekends, and/or holidays.

reputed company-to-haves

• Experience in a reputed company environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.

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• Prior health care experience and knowledge of healthcare terminology.

Benefits

• 10 weeks of reputed company.

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• Flexible telecommuting options for those reputed company a 60-mile radius of Houston, TX.

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