Provider Customer Service Representative
Description:
? Answers questions and resolves issues based on phone calls/letters from providers.
? Provide excellent customer services for high volume inbound provider calls.
? Extensive claims research on multiple platforms.
? Uses customer service threshold framework to make financial decisions.
? Processes claim referrals, new claim handoffs, nurse reviews, and provider complaints.
? Educates & assists providers on our self-service options.
? Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility.
? Performs review of member and provider claim history.
Requirements: ? Familiarity with Microsoft Office products ? Excellent computer skills using multiple screens and systems ? Experience in highly transactional call center environment ? Excellent customer service and critical thinking ? Secure, private home office location ? High speed internet access (100 mbps or higher)
Benefits:
? Full range of medical, dental, and vision benefits
? 401(k) retirement savings plan
? Employee Stock Purchase Plan
? Fully-paid term life insurance
? Short-term and long-term disability benefits
? Well-being programs
? Education assistance
? Free development courses
? CVS store discount
? Paid Time Off (PTO)
? Paid holidays
Similar Remote Jobs
Provider Customer Service Representative
Posted on: 27-02-2025 00:00
Remote Customer Service Representative
Posted on: 27-02-2025 00:00
Administrative Assistant/Data Entry Clerk
Posted on: 27-02-2025 00:00
Remote Jobs for Students
Posted on: 27-02-2025 00:00
Online Chat Support Representative
Posted on: 27-02-2025 00:00
Remote - Business Development
Posted on: 27-02-2025 00:00
Text Collector (Project Nimbus)
Posted on: 27-02-2025 00:00
Fully Remote Sales Specialist
Posted on: 27-02-2025 00:00
Remote Front Desk Attendant
Posted on: 27-02-2025 00:00
iOS Developer Retail Engineering
Posted on: 27-02-2025 00:00
Pepsico Remote Jobs (Night Shift, Full Time) $30/Hour ? Hiring Now ? Hire Me Remotely
Posted on: 23-02-2025 00:00
Remote Customer Care Chat Specialist | Start Today | Home-Based Role with Flexible Hours
Posted on: 21-02-2025 00:00
Accounting Manager - REMOTE
Posted on: 12-11-2024 02:59
Revenue Operations Associate
Posted on: 24-09-2024 00:00
Helpdesk Virtual Assistant (REMOTE) - Work From Home Jobs
Posted on: 29-08-2024 00:00
Logistics Planner, Make Ready Center
Posted on: 28-01-2025 06:21
Disney Corporate Creative Resources Digital Production Intern, Summer 2025
Posted on: 27-02-2025 00:00
Package Handler - Part Time (Warehouse like)
Posted on: 27-09-2024 00:00
Seasonal Picker/Packer ? Amazon Hiring Now in Buford, GA in Amazon (job Id: 1688011254)
Posted on: 30-12-2024 06:51
Commercial Lines Account Manager- Small Business Unit
Posted on: 19-11-2024 06:07