Clinical Operations Representative

Job Description

Job Description

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

Requirements:

• Minimum of 2 years’ experience in customer service, or healthcare operations; Required
• Associates Degree in a business or health related field is; 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

What does TurningPoint have to offer you?

Competitive Compensation for full-time employees including, but not limited to: 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.

TurningPoint is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare care patients receive. Are you seeking a place to grow in a career? Do you want to make a difference? A place where continuous learning and performance are rewarded? Start your career as a Clinical Operations Representative.