Customer Service Representative

Job Description

Job Description

Job Overview: The role requires communication between medical providers and our client as well as members. The customer service rep is to coordinate treatment and provide authorizations/issue GOP’s for members in Latin America, Europe, etc. Respond to inquiries pertaining to authorizations and documentation requirements.

Responsibilities and Duties:
• Coordinate and determine approvals, eligibility and inform the medical providers as well as issue GOP’s according to policy and client authorizations
• Tracking and follow up of all cases in Latin America ensuring appropriate follow up with the medical providers
• Provide guidance, support and advice to international members seeking medical treatments or procedures
• Responds to routine phone inquiries and written correspondence related to authorizations and claims status
• Screens and routes complex cases to the appropriate manager
• Navigates multiple systems to obtain necessary data to issue GOP’s
• Verify payments and/or denials as well as treatment authorization status and inform the appropriate party accordingly

REQUIRED SKILLS AND EXPERIENCE

• Bilingual French and English speaker
• 2+ years of experience in customer service, health insurance field a plus
• High school diploma/GED required
• Strong analytical, detail-oriented and accuracy skills are required
• Ability to manage time effectively, set priorities, meet deadlines as well as adapt to change
• Desire to work in a small entrepreneurial environment