Clinical Operations Representative

TurningPoint Healthcare Solutions; Town of Florida (NY); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Disability and life insurance

Gym discount

Paid time off (PTO)

401(k) retirement savings plan

Job summary

TurningPoint Healthcare Solutions seeks a full-time Clinical Operations Representative to assist in daily customer service tasks. Responsibilities include responding to inquiries regarding medical cases, maintaining customer relations, and ensuring the accuracy of data entry. Candidates should have at least 2 years of experience in customer service or healthcare operations, an associates degree preferred, and strong problem-solving abilities. Competitive compensation and benefits include health insurance and 401(k) plan participation for eligible employees.

Qualifications

• Minimum of 2 years’ experience in customer service or healthcare operations.
• Demonstrates dependability by following instructions and adhering to schedules.
• Strong attention to detail with problem-solving skills.
• Phone queue experience is a plus.

Responsibilities

• Responds to customer inquiries regarding medical cases.
• Documents inquiry outcomes for tracking and analysis.
• Develops and maintains positive customer relations.
• Reviews service requests for completeness.
• Handles complex calls with minimal assistance.

Skills

Customer service experience

Healthcare operations experience

Problem solving skills

Data entry skills

Microsoft Word

Microsoft Excel

Microsoft Outlook

Organizational skills

Education

Associates Degree in a business or health-related field

Job description

Position: Clinical Operations Representative

Location: Any

Job Id: 685

Number of Openings: 1

Job Description

As a Clinical Operations Representative you will assist in daily activities servicing customers including doctor's offices and patients. This will include processing requests received via telephone, fax, and e-mail and providing or validating request information. This position supports the Utilization Review Nurses in creation of the medical cases. The ideal candidate will have great attention to detail and advanced grammar and punctuation skills. This position is full-time with variable shifts.

Medical Assistant Certification, a plus!

Responsibilities

• Responds to customer questions via telephone and written correspondence regarding medical cases.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Responsible for meeting or exceeding quality and productivity expectations to ensure customer satisfaction.
• Review and maintain service requests and call center database for completeness of information.
• Handles most complex calls with minimal assistance. Provides assistance in and/or refers high-level, complex questions, problems or client complaints to appropriate resources to ensure customer satisfaction.
• Enters updates to pertinent insurance data from Document Management System or FAX into the computer system in a timely manner ensuring accuracy, completeness, and adherence to department procedures.
• Perform outbound calls to members, providers, and clients.
• Respects and maintains HIPAA confidentiality guidelines.
• Other duties as directed.

Qualifications

• Minimum of 2 years’ experience in customer service, or healthcare operations; Required.
• Associates Degree in a business or health related field; Preferred.
• Demonstrates dependability by following instructions, policies, and procedures; exceeds productivity standards, meets deadlines, and adheres to work schedules.
• Strong problem solving and troubleshooting skills with precise attention to detail.
• Phone queue experience and data entry skills; Preferred.
• Intermediate to advance proficiency in Microsoft Word, Excel and Outlook.
• Strong organizational skills and ability to multitask.

Benefits

Competitive Compensation for full-time employees including: Medical, dental, vision, disability, life, Gym Discount, and PTO. All employees, age 21 and over, are eligible to participate in the 401(k)-retirement savings plan.

Additional Information

Job Type: Full-time

CST and MST is preferred.