Medical Customer Service Representative

Customer Service Medical Rep

Chattanooga, Tennessee, United States

$ 15.00 - 17.00 (US Dollar)

Customer Service Medical Rep needs two years of experience in a customer service support role. The position requires:

• Possible COVID-19 vaccine mandate.
• Knowledge in medical terminology.
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability.
• Proficient interpersonal and organizational skills.
• Independent, sound decision-making and problem-solving skills.
• Must be able to work in an independent and creative manner.
• Self-motivated and able to manage multiple tasks and set priorities.
• Effective time management skills.
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skill.

Customer Service Medical Rep duties include:

• Supporting the area clinical team and serving as a proactive resource for members related to disease prevention and benefit education.
• Conducting educational telephone calls advising members of available benefits, services, and programs; completing health needs assessments, and referring members to population health management programs as appropriate.
• Reaching out to members with identified gaps in care; encouraging and motivating them to become compliant; offering assistance in locating providers and appointment scheduling.
• Managing system work queues; screening identified members for eligibility, prior case activities, recent claims, customer service inquiries, and authorization history; assigning members to clinical team for call outreach and intervention.
• Facilitating research and analysis of inquiries and/or complaints related to processes and designations, member lost incentives, and other program-related inquiries.
• Working overtime as needed.