High School Diploma or equivalent; some college preferred
1-2 years experience in a 'Medical' Call Center - Call Center background
Understands Medicaid, Medicare, Medical Insurance and the managed health care industry
Knowledge and experience with medical and dental claim forms
Lap top/PC and Microsoft Office proficiency
Excellent communications skills
Personal Characteristics:
Excellent attendance and work record; detail oriented
Positive attitude
High energy; enthusiastic team player
DUTIES AND RESPONSIBILITIES:
Responds to in-coming customer/'provider' inquiries and complaints while entering data in a call center environment.
Researches information, resolves issues and explains eligibility claims, appeals, and reprocessing of claims to billing providers; makes outbound calls to providers; logs all customer calls
Returns claims, when necessary, with a write-up, indicating the reason for the return