Customer Service Representative

Healthcare Support Staffing; Waltham (MA); On-site; USD 20,664 - 22,041; Full time

Benefits offered by this job

Competitive salary

Medical benefits

Dental benefits

Vision benefits

Positive work environment

Job summary

A national healthcare recruiting firm in Waltham is seeking a Customer Service Representative. This role requires handling inbound calls, addressing provider inquiries regarding eligibility and claims, and documenting resolutions in the system. Ideal candidates have a High School Diploma and at least 2 years of customer service experience, preferably in medical billing. A competitive salary between $15-$16/hour is offered based on experience. Join a dynamic team and enjoy a fun work environment with benefits including medical, dental, and vision.

Qualifications

• 2+ years of customer service experience.
• Experience with providers, medical billing, or claims.
• Commercial health insurance experience preferred.

Responsibilities

• Answer inbound calls and handle provider inquiries.
• Respond to email inquiries and secured portal messages.
• Educate providers on prior authorization requirements.
• Document all member issues and resolutions.

Skills

Customer service

Medical billing

Claims processing

Communication

Education

High School Diploma

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Job Title: Customer Service Representative

Job Description:

• Primary job function is answering inbound calls
• Handle provider inquiries regarding eligibility, benefits and claims for insurance
• Various off phone projects
• Responding to email inquiries and secured portal messages
• Investigating claim issues and following up with billing offices
• Requesting EOBs
• Call Center staff will be trained on both MA & NH plans
  

Daily Responsibilities:

• Receive and respond to all telephone inquiries from members or providers
• Research and provide information regarding member's eligibility, benefits, referrals and authorizations
• Provide members with information on the Provider Network and how to contact and access providers
• Educate providers on prior authorization requirements, how to access services and other routine, non-clinical issues
• Educate providers on process of submitting outpatient treatment requests for outpatient therapy
• Initiate or fax necessary forms to providers for outpatient services
• Coordinate with Provider Relations regarding contracting and/or credentialing status
• Document all members' issues and resolution in the computer systems
• Provide backup support to Data Entry team as necessary

Hours for this Position:

• Monday - Friday, 8:30am - 5:00pm

Compensation:

• $15 -16/hour (Negotiated based on experience)
  

Qualifications

• HS Diploma
• Experience with providers, medical billing, or claims
• 2+ years of customer service experience
• Commercial health insurance experience, preferred
• Must pass all aspects of background check to be considered for permanent position

Additional Information

Advantages of this Opportunity:

• Competitive salary, negotiable based on relevant experience
• Benefits offered: Medical, Dental, and Vision
• Fun and positive work environment

Interested in being considered?

If you are interested in applying to this position, please contact Suheyn Zambrano at [phone] ext. 112 and click the Green I’m Interested Button to email your resume.