Clinical Client Services Specialist

HealthHelp; Houston (TX); On-site; USD 30,000 - 37,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off (PTO)

401(k) with company match

Life and AD&D Insurance

Employee Assistance Program

Job summary

WNS in Houston, TX is seeking a Healthcare Customer Service Specialist to handle administrative intake for clinical reviews, provide quality service to providers, and maintain confidential data with HIPAA compliance.

You will support the Clinical Review Department, monitor KPIs, and participate in Quality Management, with opportunities for bonuses and a comprehensive benefits package.

Qualifications

• High School Diploma/GED, required
• Minimum One (1) year of Healthcare customer service (call center) experience required
• Ability to hard line internet into computer equipment provided, required
• Internet upload speed of 5 mbps and download of 25 mbps, required (verified at onboarding)
• Ability to adhere to strict schedule with ability to adapt to schedule changes, as schedules are subject to change, required
• Prior experience in a fast-paced in-bound call center environment, preferred
• HIPAA compliant room, required (verified at onboarding)
• Prior experience in the healthcare industry (i.e., prior authorizations, patient care, CPT codes, etc.), preferred
• Ability to read clinical terminology with high levels of proficiency
• Ability to work efficiently in a fast-paced, high call volume, performance driven Contact Center
• MS Outlook and Windows proficiency
• Ability to work on dual monitors and navigate multiple software applications simultaneously
• Strong time management skills
• Highly skilled at delivering client and customer satisfaction
• Must possess strong verbal and written communication skills

Responsibilities

• Conducts administrative intake and scripted clinical intake of calls for clinical review
• Provides quality customer service through interaction with providers, administrative staff and others
• Builds and maintains customer satisfaction with products and services; provides excellent service to internal and external customers
• Collects and enters confidential information ensuring the highest level of confidentiality in all areas
• Maintains high-quality documentation standards when collecting and performing data entry functions
• Provides ongoing telephonic support to providers and office staff related to HealthHelp’s Clinical Review process
• Provides administrative support to the Clinical Review Department if needed
• Participates and understands scope of responsibility pertaining to ongoing Quality Initiative Projects
• Maintains acceptable levels of performance for all Key Performance Indicators, such as Average Talk Time (ATT), Quality, and adherence to schedule
• Participates in the HealthHelp Quality Management Program as required
• Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
• Adheres to both URAC & NCQA standards in keeping with HealthHelp’s compliance initiatives
• Carries out other projects and responsibilities as assigned

Skills

Healthcare customer service

Verbal and written communication

MS Outlook

Windows proficiency

Time management

Education

High School Diploma or GED

Tools

MS Outlook

Job description

WNS in Houston, TX is seeking a Healthcare Customer Service Specialist to handle administrative intake for clinical reviews, provide quality service to providers, and maintain confidential data with HIPAA compliance.

You will support the Clinical Review Department, monitor KPIs, and participate in Quality Management, with opportunities for bonuses and a comprehensive benefits package.