Acentra Health, LLC is hiring: Call Center Representative in Tallahassee

Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. It invites problem-solving, ownership of work, and acceleration of better outcomes as part of a team dedicated to health solutions in the public sector.

This role is for a Call Center Representative supporting Wyoming Benefits Management System and Services (WY BMS) members and providers regarding programs, policies, and procedures. The position will begin remotely and may transition to a fully on-site role at our Tallahassee office at a future date. The role is located in Cheyenne, Wyoming.

Job Summary

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

This front-line service role involves answering calls related to eligibility, benefits, claims, and authorization of services. It includes administering intake documentation into the appropriate systems and delivering outstanding service to internal and external customers. The goal is to resolve member and provider needs on the first call while meeting or exceeding production and quality standards.

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 calls and process provider and member inquiries in the appropriate system
• Resolve customer service or billing issues under general supervision with sound judgment
• Contact customers to respond to complex inquiries or to notify them of claim investigation results and any planned adjustments
• Act as the first line of contact to resolve administrative concerns, including claim resolutions and expressions of dissatisfaction
• Refer unresolved grievances, appeals, and claim resolutions to designated departments for further investigation
• Keep records of customer interactions and transactions, including inquiries, complaints, comments, and actions taken
• Actively listen and probe callers to determine the purpose of the calls
• Under general supervision, research and communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries while maintaining confidentiality
• Commit to self-development and career progression; participate in ongoing training
• Educate providers on how to submit claims and when/where to submit a treatment plan
• Perform follow-up tasks to ensure member or provider needs are fully met
• Support team members and participate in team activities to build a high-performance team
• Document customers' 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 HIPAA 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 navigate multiple computer platforms while verifying information on all calls
• Flexible in scheduling and comfortable with change as customer service is dynamic

Preferred Qualifications/Experience:

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

Why Us?

We are a team of experienced leaders, clinicians, pioneering technologists, and professionals who redefine expectations for healthcare. State and federal healthcare agencies, providers, and employers rely on us to improve health outcomes.

We do this through our people.

You will have meaningful work that improves lives nationwide. We are committed to supporting our employees with the tools and encouragement needed to achieve excellent work.

Benefits

Benefits are designed to provide protection, security, and support for your career and life. Our offerings include comprehensive health plans, paid time off, retirement savings, wellness programs, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is USD 15.46 - 22.00 per hour. Pay is determined based on factors such as experience and skill level.

EEO

EEO AA M/F/Vet/Disability. Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran, or any other protected status.

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Note: Visit us at Acentra.com/careers/ for more information.