Northwood Group
Job Description
The Customer Service Representative is responsible for performing all tasks relevant to in‑house communications with the claimant’s referral source, adjuster/examiner, case manager and physician’s office for verification of eligibility or coordination of benefits and services requested. The customer service staff coordinates set‑up of pharmacy services.
Responsibilities
Answer incoming pharmacy phone calls and input information according to auto no‑fault/PIP/Workers’ Compensation criteria and diagnosis
Maintain open line of communication with claimants, care givers, case managers, adjusters/examiners, physician’s offices, hospitals and referral source
Respond to claimants’ questions and concerns
Set‑up new claimant files, verifying eligibility information for full or coordination of benefits
Send Letter of Medical Necessity requests for physician involvement in ordering supplies or medications
Verify claimants address and telephone number for each delivery
Review order for completeness and accuracy before faxing order to Northwood provider for set‑up
Conduct surveys for new and current claimants
Provide after‑hours on‑call responsibilities
Perform other related duties assigned by the Program Manager/Assistant Program Manager
Comply with all company information security policies and responsibilities as detailed during onboarding and annual security awareness training
Qualifications
High School Graduate, GED
Home Health Aide (HHA) certification, Nursing Assistant certification, or Hospital Unit Clerk preferred, not required
Data entry experience
Excellent phone and customer related communication skills
Ability to communicate clearly, both verbally and in writing
Ability to multi‑task to meet established deadlines
Ability to prioritize workflow
Ability to work effectively with a wide range of people including referral sources, claimants, clients, physician offices, case managers, co‑workers and management
Computer and typing skills
Adaptable to varied work environments with or without reasonable accommodation
Company Description Northwood plays an integral role in health plan benefit administration for durable medical equipment, prosthetics, orthotics and medical supplies. Northwood also serves auto and workers compensation clients and their PIP claimants.
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Responsibilities
Answer incoming pharmacy phone calls and input information according to auto no‑fault/PIP/Workers’ Compensation criteria and diagnosis
Maintain open line of communication with claimants, care givers, case managers, adjusters/examiners, physician’s offices, hospitals and referral source
Respond to claimants’ questions and concerns
Set‑up new claimant files, verifying eligibility information for full or coordination of benefits
Send Letter of Medical Necessity requests for physician involvement in ordering supplies or medications
Verify claimants address and telephone number for each delivery
Review order for completeness and accuracy before faxing order to Northwood provider for set‑up
Conduct surveys for new and current claimants
Provide after‑hours on‑call responsibilities
Perform other related duties assigned by the Program Manager/Assistant Program Manager
Comply with all company information security policies and responsibilities as detailed during onboarding and annual security awareness training
Qualifications
High School Graduate, GED
Home Health Aide (HHA) certification, Nursing Assistant certification, or Hospital Unit Clerk preferred, not required
Data entry experience
Excellent phone and customer related communication skills
Ability to communicate clearly, both verbally and in writing
Ability to multi‑task to meet established deadlines
Ability to prioritize workflow
Ability to work effectively with a wide range of people including referral sources, claimants, clients, physician offices, case managers, co‑workers and management
Computer and typing skills
Adaptable to varied work environments with or without reasonable accommodation
Company Description Northwood plays an integral role in health plan benefit administration for durable medical equipment, prosthetics, orthotics and medical supplies. Northwood also serves auto and workers compensation clients and their PIP claimants.
#J-18808-Ljbffr