Customer Service Specialist

JOB SUMMARY The Customer Service Representative is responsible for the receipt of new cases and ensuring proper system drafting and setup. The CSR is also responsible for taking direction and facilitating the case assignment/scheduling process. Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other, and Dane Street. It is the responsibility of all of us to maintain a positive working environment that promotes client satisfaction and results. MAJOR DUTIES & RESPONSIBILITIES Handling Receipt of New Cases: Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street systems. Work with the client on any missing information pertinent to processing the claim. Sort, organize, and create a medical document listing, if required by the client, in line with specific special handling. Respond to inbound calls, emails, and portal inquiries. Maintain efficient and accurate records related to all client interactions. Ensure compliance with Federal NSA regulations, processes, and policies. Collaborate with the Leadership team and other departments to ensure timely resolutions Ability to process and interpret reporting. Adhere to or exceed metrics/goals. Assignment of Cases: Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements. Ensure that the assigned physician has no conflict of interest with the case assignment. Oversight of Cases: Monitor, process, and track cases to ensure we meet deadlines. Client Interaction: Update clients frequently on cases in progress. May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer. Ensure proper documentation for specified cases is provided to the client. Maintain consistent professionalism at all times Other duties & special projects, as assigned and based on business needs. EDUCATION/CREDENTIALS: An Associate’s Degree is preferred. JOB RELEVANT EXPERIENCE: Business experience in a healthcare and/or insurance setting is preferred. Healthcare claims and billing Conflict resolution and de-escalation skills JOB RELATED SKILLS/COMPETENCIES: Present exceptional communication skills with a clear understanding of the company's business lines. The ability to apply critical thinking, manage time efficiently, and meet specific deadlines. Computer literacy and typing skills are essential. Customer focus, problem-solving, professionalism, integrity, customer excellence, and time management WORKING CONDITIONS/PHYSICAL DEMANDS: Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work. WORK FROM HOME TECHNICAL REQUIREMENTS: Supply and support their own internet services. Maintaining an uninterrupted internet connection is a requirement for all work from home position. This job description is subject to change at any time. Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.