To provide quality customer service while effectively accepting and responding to customer calls and inquiries regarding network providers. Effectively accept and respond to customer's calls and inquires regarding network related questions such as request to add provider/hospital to the network, fee schedule research, and contract clarifications. Document all cases according to established policies and identify cases that need further review by BIRT team
Essential Functions:
- Resolves and inputs provider/client requests into tracking system according to established guidelines. Ensures proper, accurate records, files, databases are set up and maintained.
- Document all inquiries within contact management system, follows appropriate guidelines for notepad documentation, and assigns case accordingly.
- Ability to use and interpret multiple systems for claims research, contract interpretation, Fee Schedule rates and provider network status
- Ability to interpret and understand claim systems
- Capacity to understand and interpret client and provider contracts while working with callers
- Provides customer satisfaction to both internal and external customers and strives to continuously improve service delivery.
Requirements:
- High School Diploma
- 1 + years' customer service experience
- Familiarity with telephone techniques and skills
- Ability to utilize PC keyboard efficiently and accurately. Proficient data entry skills.
- Working knowledge of personal computers and ability to navigate through software applications.
- Demonstrated verbal communication skills and ability to convey information clearly and effectively
- Ability to effectively handle multiple tasks in a fast paced environment
- Ability to identify problem issues and determine the appropriate course of action/redirection within department guidelines required to resolve issues
- Ability to resolve issues of conflict in a tactful and professional manner and to effectively diffuse irate callers
Desired:
- Demonstrates an understanding of healthcare/managed care industry, types of services and general business processes
- Demonstrated problem solving skills
- Medical and Claim Terminology
- Telephone experience in similar call center environment and/or industry
MultiPlan is an equal opportunity of employer M/F/D/V
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