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Serve as the advocate for providers by demonstrating accountability and ownership to resolve issues.
Service providers in a multi-channel environment including call and concurrent chat as required.
Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices).
Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).
Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.
Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.
Strong multi-tasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.
Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.
Requirements
High School Diploma / GED OR equivalent work experience.
Must be 18 years of age OR older.
1+ years of customer service experience with analyzing and solving customer's concerns.
Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
Ability to type at a speed of greater than OR equal to 35 - 40+ WPM (words per minute) with an accuracy of 90%.
Ability to work any full-time (40 hours / week) shift between the hours of 10:35 AM - 7:05 PM CST from Monday - Friday.
Nice-to-haves
Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.
Prior health care experience and knowledge of healthcare terminology.
Benefits
10 weeks of paid training.
Flexibility to work remotely if located within a 60-mile commutable distance of Houston, TX.
