Temp to Perm – Non-Clinical – Customer Service Representative (Days) Indianapolis, IN

US, IN
3

Job 
Detail

Title: Temp to Perm – Non-Clinical – Customer Service Representative (Days) Indianapolis, IN

Description:

Remote with onsite/virtual training. Work from home position after training completion

Position Summary:

This position will be responsible for daily member telephone calls which will include directing
members to the proper services needed, educating members, problem solving, and creating
linkages to the Medical Management Department for authorization of services. Also may be
responsible for assisting providers with eligibility, benefit, and resolution of claims issues.

Essential Functions and Responsibilities:

1. Meet the Department standard of calls answered, and call documentation entered.

2. Assist Members and Providers with questions and concerns.

  • Finding Provider(s)/Services for members
  • Arrange Transportation for members
  • Answer billing/claims status questions; resolve claim issues for members
  • Assist with pharmacy issues
  • Help Members access community support services
  • Verify member eligibility
  • Quote benefits
  • Assist with Referrals
  • Assist with member health assessments
  • Assist members with closing gaps in care

3. Ongoing member education.

4. Responsible for all benefits information given to Members and Providers.

5. Participate in Departmental Projects, as appropriate.

6. Coordinate quality improvement initiatives with Medical Management, Provider Relations,
and Quality Depts., i.e., Preventative Health Screenings.

7. Other duties as assigned or when necessary to maintain efficient operations of the
department and the Company as a whole.

*** This is a 52% markup need. Contractors need to make a facility mandated *** per hour ***

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