Customer Service Representative

Talentify; Harrisburg (Dauphin County); On-site; USD 19,000 - 25,000; Full time

Job summary

Talentify is seeking a Customer Service Representative to support the Medicare Appeal process onsite in Harrisburg, PA. The role requires handling calls, resolving questions and requests, and adhering to internal policies to meet quality standards.

Responsibilities include data entry, logging inquiries, and acting as a liaison between supervisors and providers while maintaining accurate records and timely responses.

Qualifications

• 2+ years customer service/telephone experience in a call center environment or industry
• Ability to effectively communicate with team members and external customers
• Ability to research and resolve Medicaid program and service eligibility issues

Responsibilities

• Develops and maintains working knowledge of internal policies, procedures, and services
• Uses automated systems to log and retrieve information and perform data entry
• Receives inquiries by telephone, email, fax, or mail and responds within required turnaround times
• Responds to telephone inquiries and complaints in a prompt, courteous manner following procedures
• Interacts with hospitals, physicians, beneficiaries, or other program recipients
• Investigates and resolves or reports customer problems and escalates difficult situations
• Meets or exceeds call volume and service level standards
• Initiates files by collecting and entering demographic, provider, and procedure information
• Serves as liaison between Review Supervisors and external providers
• Maintains logs and documents disposition of calls

Skills

Customer service

Communication

Telephone support

Problem solving

Data entry

Education

High School diploma or equivalent

Tools

Microsoft Office Suite

PC proficiency

Job description

Position Status Label: Non- Exempt

Labor Category: Customer Support

Remote/Onsite: Onsite

Additional Informations:

The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization’s services to meet productivity and quality standards.

Responsibilities:

• Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes
• Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
• Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
• Interacts with hospitals, physicians, beneficiaries, or other program recipients
• Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party
• Meets or exceeds standards for call volume and service level per department guidelines
• Initiates files by collecting and entering demographic, provider, and procedure information into the system
• Serves as liaison between the Review Supervisors and external providers
• Maintains logs and documents disposition of incoming and outgoing calls

Required Qualifications:

• High School diploma or equivalent
• 2+ year’s customer service/telephone experience in a similar call center environment and/or industry.
• Must have ability to effectively communicate with team members and external customers
• Must have ability to research and resolve issues related to Medicaid program and service eligibility

Preferred Qualifications:

• Previous experience in the medical office or other medical setting preferred
• General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
• Knowledge of CPT and HCPCS codes preferred
• PC proficiency to include Microsoft Office Suite
• Experience with Microsoft programs