Customer Service Representative (Remote within CA)
Acentra Health, United States

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Customer Service Representative (Remote within California)

• Are you an experienced Customer Service Representative looking for a new challenge?
• Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

If so, you might be our next new team member!

IMPORTANT NOTES:

** Hourly rate: $19.23 per hour **

** This is a full-time, direct-hire role with Benefits. **

** Hours: The selected candidate will be required to work 8:00 AM 6:00/PM Pacific, Monday through Friday.

** The selected candidate will be required to reside and work within the State of California. **

Who we need:

The Customer Service Representative will be responsible for supporting the authorization process by:

Answering incoming telephone calls.

Resolving customer questions, complaints, and requests.

Adhering to internal policies and procedures.

Utilizing working knowledge of the organization’s services to meet productivity and quality standards.

Ability to complete Treatment Authorization Request (TAR) forms for processing claims.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

What you’ll do:

• Develop and maintain a working knowledge of internal policies, procedures, and services (both departmental and operational).
• Utilize automated systems to log and retrieve information.
• Perform accurate and timely data entry of electronic faxes.
• Receive inquiries from customers or providers by telephone, email, fax, or mail and communicate responses within required turnaround times.
• Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures.
• Interact with hospitals, physicians, beneficiaries, or other program recipients.
• Investigate and resolve or report customer problems. Identify and escalate difficult situations to the appropriate party.
• Meet or exceed standards for call volume and service level per department guidelines.
• Initiate files by collecting and entering demographic, provider, and procedure information into the system.
• Ability to complete Treatment Authorization Request (TAR) forms for processing claims.
• Serve as liaison between the Review Supervisors and external providers.
• Maintain logs and document the disposition of incoming and outgoing calls.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications / Experience

• High School diploma OR GED OR equivalent education.
• 2+ years of customer service/telephone experience in a similar call center environment and/or industry.
• Medical terminology course(s).
• Medical billing experience (e.g., Treatment Authorization Request (TAR) forms for processing claims).

Preferred Qualifications / Experience</

Job Rewards and Benefits