Note: The job is a remote job and is open to candidates in USA. MedWatch, LLC is seeking a Concierge Customer Service Representative to provide excellent customer interaction skills. This role involves responding to customer inquiries, assisting members with benefits and healthcare questions, and documenting all communications.
Responsibilities
- Respond to telephone and email inquiries received from members and provider within defined service standards. Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers
- Assist members with benefits and healthcare questions
- Document all calls received in system-based call log
- The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice
Skills
- Minimum HS Diploma/GED
- One year Customer Service / Call Center experience in a health care related role
- Patience and ability to handle difficult situations tactfully and diplomatically
- Strong customer relations, interpersonal skills
- Strong appreciation and ability to handle confidential & sensitive information
- Proficient with Microsoft applications, strong computer skills and computer navigation
- Excellent data entry and typing skills
- Knowledge of provider organizations and networks
- Knowledge and understanding of CMS Medicare reimbursement rates
- Ability to effectively negotiate rate structures
- Takes initiative to resolve situations and to accomplish projects actions and tasks
- Excellent verbal and written communication skills
- Independent judgment in decision making and problem solving
- Ability to multi-task and anticipate potential needs/problems
- Ability to build relationships with internal and external customers
- Medical Terminology
- Strong attention to detail
- Strong analytical and research skills
- 2 years college or higher education
- Medical Intake or Third-Party Administrator (TPA) experience
- Bilingual English-Spanish
- Understanding of Self-Funded health benefits
- Claim processing skills
- Insurance verification or pre-certification
- Provider office/facility billing department or financial area
Company Overview
Since 1988, MedWatch has been a leader in providing concierge member advocacy and medical cost containment solutions for TPAs, employer groups, school systems, municipalities, hospital systems, Taft-Hartley plans, and fully insured payers as well as for the reinsurance industry and stop loss carriers. It was founded in 1988, and is headquartered in Lake Mary, Florida, USA, with a workforce of 201-500 employees. Its website is https://www.urmedwatch.com/home/.
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