Presbyterian Healthcare Services

Presbyterian Healthcare Services is a nonprofit hospital system, health plan, and medical group which provides services for over 660,000 residents of New Mexico

Call Center Representative Health Plan

Location

New Mexico

Posted

1 day ago

Salary

$15 - $23 / hour

Seniority

Senior

No structured requirement data.

Job Description

Call Center Representative Health Plan

Presbyterian Healthcare Services

Title: Call Center Representative Health Plan Location: New Mexico, USA Job Description: Full time job requisition id R-5570 Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $15.99 Maximum Offer $23.76 Now Hiring: Call Center Representative Health Plan Summary: Please note. This role is a work at home role available for New Mexico residents only at this time. Build your Career. Make a Difference. Presbyterian is hiring a skilled Call Center Representative to join our team. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America) Responsibilities: Responsible for providing customer service for members and providers in all PHP benefit plans. Ensure callers receive service excellence when responding to telephone, written, Pres Online, E-Business, chat and in person inquires. Some key responsibilities include - High school diploma plus one to three years office/business experience; call center experience preferred and/or is currently demonstrating customer service skills, meeting current department metric and attendance guidelines within department. - Claims processing experience in managed care with possible enrollment experience is preferred. - Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff. Written communication skills as well as business writing and presentation skills are required. - Requires strong organizational skills, ability to create, sort and analyze reports (Excel, Access, etc) and system processes. - A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc and some knowledge of risk sharing programs helpful. - Some knowledge of CRM and Facets, as well as any other databases that may be used PHS Enterprise wide. - Demonstrated ability to function effectively as a team member. Requires ability to retain plan details and basic medical terminology. - Must be able to work cooperatively with other employees and function under pressure. Demonstrated ability to sustain quality standards. Must be able to prove ability to type 30 wpm with 90% accuracy. Qualifications: - High school/GED diploma - One year office/business experience - Call Center experience preferred. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Related Categories

Related Job Pages

More Call Center Representative Jobs

Mercy logo

Registered Nurse Telestroke - vNeuro Outpatient

Mercy

The seventh-largest Catholic health care system in the nation, Mercy is an integrated organization comprised 46 hospitals and 700 outpatient locations throughou

Support evidence-based stroke care by collaborating with a multidisciplinary team, maintaining patient confidentiality, and ensuring quality practices across multiple hospitals while managing patient care throughout the continuum.

Missouri
ContractRemoteTeam ,H1B No Sponsor

• Contactarnos con clientes de otro operador a que pasen a ser parte del equipo de claro

Peru
IQVIA logo

Care Manager - Patient Support Call Center

IQVIA

Accelerate innovation for a healthier world.

Full TimeRemoteTeam 10,001+H1B Sponsor

Title: Care Manager – Patient Support Call Center -Remote Locations: Pocatello, United States of America / Phoenix, United States of America Las Vegas, United States of America Olympia, United States of America Redondo Beach, United States of America Salem, United States of America San Jose, United States of America Vancouver, United States of America R1532044 Job Description: Care Manager - Patient Support Call Center - Remote Philadelphia, United States of America | Full time | Home-based | R1532044 Job available in additional locations Apply Now Share this job This is posted in anticipation of a future role Position Summary: Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance, and check prior authorization and/or appeal status. The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee. Care Manager As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is acting as the biopharma's sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world. Responsibilities will vary by program and its lifecycle. Care Manager's may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance, and check prior authorization and/or appeal status. Care Managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position. Job Responsibilities: • Perform outbound calls to obtain appropriate information and document accurately. • Responsible for answering in-bound calls and assisting customers with pharmacy-related services. • Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service. • Contact insurance companies for benefit investigation and coverage eligibility. • Provide prior authorizations and appeals support. • Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs. • Update job knowledge by participating in educational opportunities and training activities. • Work efficiently both individually and within a team to accomplish required tasks. • Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's. • Report ADE's according to program policy and guidelines. • Adhere to all HIPAA guidelines. • May assist with onboarding new employees. Schedule: Must be available for an 8-hour shift between 8am-8pm EST. Required Qualifications: • High School Diploma or equivalent • Minimum one year of experience in medical billing, reimbursement, insurance verification, or similar related medical office experience. • Previous data entry experience (minimum three months) and ability to type 30wpm+. • Able to demonstrate high attention to detail in work. • Must be computer savvy, including navigating multiple computer tabs, monitors, and applications. • Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc.) and soft phone systems (WebEx, Mitel, Shoretel, etc.). • Exceptional communication skills, both written and verbal. • Able to work in a virtual team environment by being available and responsive during working hours. • Excellent follow-through. Preferred Qualifications: • Some College. • Bilingual Spanish - English. • Previous experience in Patient Support Services (Hub). • Previous Customer Service experience in the healthcare field. About IQVIA: IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism. **The potential base pay range for this role is $22.00 - $24.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits. Apply Now

Idaho + 6 moreAll locations: Idaho | Arizona | Nevada | Washington | California | Oregon | Canada
$22 - $24 / hour
Hackensack Meridian Health logo

Contact Center Representative

Hackensack Meridian Health

Headquartered in Edison, New Jersey, Hackensack Meridian Health is a nonprofit healthcare organization founded in 1997. Formerly known as Meridian Health, the o

Title: Contact Center Representative - Iselin (Metropark) Location: Iselin United States ShiftDay StatusFull Time with Benefits Job Description: Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Contact Center Representative will handle multi-channel requests in a fast-paced centralized contact center environment, interacting with patients, families and clinical staff to schedule appointments, register patients and handle other medical requests. This role interacts with a diverse customer base to assist with questions, concerns or problems with a focus on first contact resolution, providing exceptional customer service, striving to anticipate and meet the needs of HMH consumers, treating all consumers and colleagues with dignity and respect, and working collaboratively to achieve quality and performance standards. Multiple hybrid positions open in both our Iselin and Tinton Falls locations Hybrid positions with 90% work from home and 10% working onsite after completing the fully onsite training period of approximately 6 weeks at the start of employment and candidates need to be available for the entire duration. Training can require you to travel to both locations. Schedules are created between 7:30am - 7:00pm Monday through Friday as well as Saturdays 8:30am - 12:00pm (rotating basis as needed). Saturday shift (remote) provides a day off during the week. Responsibilities A day in the life of a Contact Center Representative with Hackensack Meridian Health includes: - Answer incoming calls, emails and chats to accurately schedule, re-schedule, or cancel appointments according to guidelines and established protocols. - Perform new patient pre-registration. Positively verifies/updates patient identity, demographics, insurance and all other data as required. - Collaborate with patients, medical practices and various insurance companies to ensure that authorizations are obtained in a timely fashion. - Ensures accuracy in all required demographic, financial, referral/authorization, clinical, and other registration data is accurately scheduled, collected, verified, and communicated. - Utilize current Electronic Health Record (Epic) to perform transactions and accurately and efficiently document and route messages to the appropriate practice. - Respond to patient portal requests and educates patients on the use and benefits of the patient portal. - Assists with locating a primary care or specialty provider with appropriate referrals within the health system. - Collaborates, communicates and coordinates to create a positive patient experience. - Assists patients with any questions and resolves calls with minimal outside direction by researching and exploring answers, alternative solutions, implementing solutions, and escalating unresolved problems. - Required to meet specific performance metrics of productivity and quality assurance. - Adheres to all established workflows, scripting, and department call flow. - Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified to interact with a variety of customers including patients, practice staff, physicians, colleagues and leaders. - Performs other job-related duties as required. - Adheres to HMH Organizational competencies and standards of behavior. Qualifications Education, Knowledge, Skills and Abilities Required: - High School diploma, general equivalency diploma (GED), and/or GED equivalent programs. - Minimum of 1 year of previous experience working in a customer service, customer facing (i.e., retail or hospitality) or call center environment. - Effective verbal, written and interpersonal communication skills. - Strong telephone soft skills gained from prior customer/patient experience in a similar role or in a call center environment type role. - Possess a true patient first attitude, and a passion for assisting patients and delivering a differentiating patient experience on every contact. - Clear speaking voice. - Outstanding work ethic and strong adherence to shift schedule (may include overtime and weekend work). Education, Knowledge, Skills and Abilities Preferred: - Associate's or Bachelors degree. - 1 year of healthcare experience as a Medical assistant or assisting patients in any capacity. - 2 years of previous experience working in an inbound call center environment. - Previous experience using EPIC system. - Knowledge of medical terminology, hospital systems, and insurance processes. - Bilingual- Spanish. If you feel that the above description speaks directly to your strengths and capabilities, then please apply today! Compensation Minimum rate of $21.78 Hourly HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: - Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. - Experience: Years of relevant work experience. - Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. - Skills: Demonstrated proficiency in relevant skills and competencies. - Geographic Location: Cost of living and market rates for the specific location. - Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. - Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits. HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.

New Jersey
$0 / hour