Position Summary
This position is responsible for answering telephone calls in a prompt, courteous, professional manner and acting as a liaison between Primary Care Associates of CA/Unilogic Healthcare Management, LLC and members; contracted and non-contracted care providers, ancillary providers; health plans; billing companies; collection companies, to provide assistance and respond to service requests. You will have 30/60/90-day evaluations to determine if the essential duties and responsibilities are being met and if you have passed the 90-day probationary period.
Essential Responsibilities
Assist customers on the telephone with inquiries, updates, changes related but not limited to claims, eligibility, referrals, billing, access, transportation, and general coordination of care through thorough
research in a timely manner.
The monthly expectation is to perform at a quality level of 90% accuracy of all measures.
The daily expectation is to efficiently answer a minimum of 60 calls per day (inbound).
100% thorough documentation of every call.
Thoroughly verify HIPAA requirements to ensure account accuracy.
Follow up on all open issues.
Communicate recurring issues and trends to management.
Representative is responsible for being a resource for other team members.
Assist with member outbound calls as needed.
All other duties as assigned.
Qualifications
High School Diploma or equivalent experience
A minimum of two (2) years of customer service experience in a call center environment required.
Ability to multitask, prioritize and work in a fast-paced environment.
Knowledge of HIPAA transaction sets, regulations/privacy laws
Skills and Abilities
Computer literate (Excel, Word, Etc.).
Excellent communication, organization, and customer service skills.
Proven ability to problem-solve and complete projects with-in appropriate time frames.
Strong attention to details.