MedWatch, LLC logo
MedWatch, LLC

Population Health Management - The RIGHT CARE at the RIGHT TIME in the RIGHT PLACE at the RIGHT COST

Concierge Customer Service Representative II

Customer SupportCustomer SupportFull TimeRemoteMid LevelTeam 201-500Since 1988H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

2 days ago

Salary

$19 - $20 / hour

Seniority

Mid Level

Associate Degree2 yrs expExperience acceptedEnglish

Job Description

Concierge Customer Service Representative II

MedWatch, LLC

• 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. • Handle all incoming MedWatch precertification calls (i.e., start cases, do call logs, forward calls, provide case status, provide claims phone #’s, etc.) • Make outgoing calls for MedWatch (demos, information for case completion, re-direction for network steerage, etc.) • Complete incoming electronic Web-certs. • Verify patient and provider demos – correct and/or complete when needed.

Job Requirements

  • 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.
  • Patience and ability to handle difficult situations tactfully and diplomatically.
  • 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 & anticipate potential needs/problems.
  • Ability to build relationships with internal and external customers.
  • Medical Terminology
  • Strong attention to detail.
  • Understanding of Self-Funded health benefits a plus.
  • Health Payor background preferable in self-funded industry a plus.
  • Claim processing skills a plus.
  • Insurance verification or pre-certification a plus.
  • Provider office/facility billing department or financial area.
  • TPA experience a plus.
  • Strong analytical and research skills.
  • Bilingual a plus

Benefits

  • paid time off
  • medical
  • dental
  • vision
  • short and long-term disability
  • life insurance
  • AD&D
  • 401k with match
  • critical illness coverage
  • legal plan
  • identity theft coverage
  • pet insurance
  • discount programs

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