Robert Half International Provider Services Medical Claims Representative in INDIANAPOLIS, Indiana
Robert Half Healthcare Practice has partnered with a well-known healthcare company in Plainfield to secure a full-time Provider Services Medical Claims Representative with a flexible schedule. This person must have customer service experience as well as experience in medical billing!
This person must be available to work Monday - Friday and an 8-hour shift between the hours of 8:00am and 8:00pm.
-? Receive and respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources
? Research and provide information regarding member?s eligibility, benefits, referrals and authorizations
? Provide assistance to members and/or providers regarding website registration and navigation
? Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
? Educate providers on prior authorization requirements, how to access services and other routine, non-clinical issues and process for submitting outpatient treatment requests for outpatient therapy
? Maintain performance and quality standards based on established call center metrics including turn-around times
? Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment
? Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction
For immediate consideration, please send your resume directly to firstname.lastname@example.org
Customer Service Experience - at least 1 year of call center customer service experience, preferably in a Medicare, Medicaid managed care or insurance environment
High school diploma or equivalent
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