Customer Service Ops Support Specialist

Remote JOB TITLE: Customer Service Operational Support Location: Remote DEPARTMENT:Customer Service/Intake FLSA STATUS: Non-exempt OVERVIEW: To support Customer Service Operations for all service products in all lines of business ESSENTIAL DUTIES AND RESPONSIBILITIES: Process EOB Request in Document Manager Inbox. Completes outgoing Billing provider calls to request bill/medical records. Claim message handling all carriers. Solely maintain/address CSBilling mailbox inquires daily. Solely maintain/address CSIntake mailbox inquires daily. Distribute daily WC Hospital notifications- sent daily by supervisor. Complete daily FROI report and send to WCMC by 2pm daily (Back only) Research and distribute Request for Precert (RFP Inbox) forwarding back to Precert, Carrier or provider. Specialize process Allstate NIS/ Precert request. Enter and distributes FROIs as assigned. Enters new Intake/Referrals into SYSTEM. Advises Customer Services/Intake Supervisor of activities and problematic issues. Utilizes various department Trackers (Productivity, Billing Tracker, Email) to track daily production. Login as “New Login” to CCS to be available as back up phone agent. FROI Mailbox distribution/Q&A (back up) Process updates to PE List, Employer Manager. Maintenance of FROI Right Fax address book. Can Assist with training. Completes other tasks as assigned by Customer Service/Intake Supervisor KNOWLEDGE: Knowledge of daily customer service operations and principles,including customer needs assessment, meeting quality standards for services andevaluations of customer satisfaction. Knowledge of corporate and departmental policies and procedures. Possess’ working knowledge of pre-cert, worker’s comp, group health, PPO lookup,and Bill Review process. Knowledge of insurance carrier plans Knowledge of administrative and clerical procedures and systems such as wordprocessing, managing files and records, designing forms and other office procedures andterminology. Knowledge of the structure and content of the English language including the meaningand spelling of words, rules of composition and grammar. Knowledge of computer hardware and software Knowledge of medical coding, i.e., CPT codes, ICD-9 codes, HCPCS codes Knowledge of office equipment, i.e., telephone, computer, fax machine, copy machine,printer, e-copy scanner, calculator. SKILLS Bilingual Spanish highly preferred. Must have moderate analytical skills, to sift through verbal and written information inorder to make a decision in relation to the problem presented. Must be able to remain focused on the issue at hand without digressing to non-relatedmatters. Monitor and assess own performance and make improvements and or take correctiveaction. Excellent Communication Skills Excellent Computer/Data Entry Skills EDUCATION, EXPERIENCE AND TRAINING: High School Diploma required. College Diploma or Certified Course Work preferred. Minimum of two years Customer Service experience required. Managed Care, Health Care, Doctors’ office/facility experience preferred. PHYSICAL DEMANDS: None must be carried out by an employee to successfully perform the essential functions of this. #J-18808-Ljbffr Medlogix