CSR/ Member Service Rep

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 Position Purpose: Receive and respond to telephone inquiries from members or providers regarding eligibility, benefits and authorization of services. Educate callers on behavioral health program and procedures. Position 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 therapy 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 Qualifications Must have a High school Diploma or GED equivalent, from an accredited school Must have good communication skills Must have Health Care Experience Must be computer proficient: Microsoft Office, Word and Excel, Typing skills 30 WPM or above. Additional Information Are you an experienced Registered Nurse with Corporate training experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes #J-18808-Ljbffr