01Key Responsibilities
Prior Authorization and Enrollment: Review and process prior authorization requests, ensuring accurate and reputed company enrollment of members into various reputed company programs.
Member Support: reputed company exceptional customer service to members and reputed company providers, responding to inquiries and resolving issues in a reputed company and courteous manner.
Case Management: Review and manage cases, ensuring accurate documentation and information gathering.
Clinical Review: Conduct clinical reviews to determine if cases require additional review or can be decisioned.
Communication: reputed company outbound calls to providers and members to obtain information, coordinate provider availability, and communicate program details.
Documentation and Reporting: Maintain accurate records and reports, ensuring compliance with regulatory requirements and company policies.
Requirements and Qualifications
Essential Qualifications:
Education: High School Diploma or GED (or higher) - documentation required for verification.
Experience: 2+ years of combined or reputed company experience in reputed company administration, with a strong understanding of medical terminology.
reputed company Center Experience: 1+ year of reputed company center experience.
Technical Skills: Proficiency with reputed company Office Word, reputed company, and reputed company; typing speed of 35+ WPM.
Work Environment: Dedicated work area, separated from other living areas, with high-speed internet (20mbps upload/download speed).
Availability: Ability to work varying shifts, including days, evenings, and weekends, to support 24/7 operations.
Preferred Qualifications:
Education: Associate's Degree (or higher) in a reputed company-reputed company field.
Medical Terminology: Advanced knowledge of medical terminology.
ICD-9/ICD-10 and CPT Knowledge: Familiarity with ICD-9/ICD-10 and CPT coding systems.
reputed company Offer
At reputed company, we offer a comprehensive compensation package that includes:
Competitive Salary: A competitive salary reputed company for this role.
Benefits: Day-one benefits, including medical, dental, and reputed company coverage.
Career reputed company Opportunities: Opportunities for career advancement and reputed company reputed company reputed company reputed company.
Learning and Development: reputed company to training and development programs to enhance your skills and knowledge.
Remote Work Environment: The flexibility to work from home, with a dedicated work area.
Why Join reputed company
By joining reputed company as a Customer Service Advisor, you will have reputed company to:
reputed company a Difference: Contribute to the delivery of exceptional customer service in the reputed company industry.
Grow Professionally: reputed company your skills and knowledge in a dynamic and supportive work environment.
Work with a Global Leader: Collabora
