Call Center Representative Job at Acentra Health in Tallahassee

Overview

Join to apply for the Call Center Representative role at Acentra Health.

This Call Center Representative is a front-line service position aiding Wyoming Benefits Management System and Services (WY BMS) members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall, the role aims to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. This position is located in Cheyenne, Wyoming.

Job Summary

This position will begin as a remote role. However, at a future date (to be determined), the position will transition to a fully on-site role at our Tallahassee office.

Responsibilities

• Available to work from 7:00 AM to 6:00 PM Mountain Time on all State business days, Monday through Friday (excluding Wyoming State holidays)
• Accurately respond to inbound phone calls and process provider and member inquiries and requests into the appropriate system and database
• Resolve customers’ service or billing complaints under general supervision by demonstrating sound judgement
• Contact customers to respond to complex inquiries or to notify them of claim investigation results and any planned adjustments
• Resolve customer administrative concerns as the first line of contact, including claim resolutions and other expressions of dissatisfaction
• Refer unresolved customer grievances, appeals, and claim resolution to designated departments for further investigation
• Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
• Actively listen and probe callers in a professional and timely manner to determine the purpose of the calls
• Research and communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries while maintaining confidentiality
• Participate in ongoing training sessions to support self-development and career progression
• Educate providers on how to submit claims and when/where to submit a treatment plan
• Perform necessary follow-up tasks to ensure member or provider needs are completely met
• Support team members and participate in team activities to help build a high-performance team
• Document customer comments/information and forward required information to the appropriate staff
• Escalate calls to Call Center Lead when necessary
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Qualifications

Required Qualifications/Experience:

• High School graduate or GED
• At least 1 year of customer service-related experience
• Experience with computer applications, such as Microsoft Word and PowerPoint
• Proficient typist (avg. 35+ WPM) with strong written and verbal communication skills
• Ability to maneuver through various computer platforms while verifying information on all calls
• Flexibility in scheduling and comfort with change as customer service is an ever-changing environment

Preferred Qualifications/Experience:

• Bilingual Spanish speaking
• Call center experience
• Healthcare industry experience
• Medicaid experience

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.

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

Benefits are a key component of your rewards package. Our benefits are designed to provide 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.

Compensation

The pay range for this position is USD $15.46 - USD $22.00 per hour. “Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

EEO

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Pay Range

USD $15.46 - USD $22.00 /Hr.

Seniority level: Entry level

Employment type: Full-time

Job function: Other

Industries: Government Administration