Customer Service - OnSite start date 12/19/24

AppleOne - Swatara, PA

Full-time - Entry Level

Swatara, PA

Administrative and Support Services

About the position

The Customer Service Representative plays a crucial role in supporting the Medicare Appeal process by addressing customer inquiries and resolving issues. This position requires adherence to internal policies and procedures while utilizing knowledge of the organization's services to meet productivity and quality standards.

Responsibilities

• Develop and maintain working knowledge of internal policies, procedures, and services.
• Utilize automated systems to log and retrieve information.
• Perform accurate and timely data entry of electronic faxes.
• Receive inquiries from customers or providers by telephone, email, fax, or mail and communicate responses within required turnaround times.
• Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures.
• Interact with hospitals, physicians, beneficiaries, or other program recipients.
• Investigate and resolve or report customer problems.
• Identify and escalate difficult situations to the appropriate party.
• Meet or exceed standards for call volume and service level per department guidelines.
• Initiate files by collecting and entering demographic, provider, and procedure information into the system.
• Serve as liaison between the Review Supervisors and external providers.
• Maintain logs and document disposition of incoming and outgoing calls.

Requirements

• High School diploma or equivalent.
• 2+ years' customer service/telephone experience in a similar call center environment and/or industry.
• Ability to effectively communicate with team members and external customers.
• Ability to research and resolve issues related to Medicaid program and service eligibility.

Nice-to-haves

• Previous experience in the medical office or other medical setting preferred.
• General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred).
• Knowledge of CPT and HCPCS codes preferred.
• PC proficiency to include Microsoft Office Suite.

Benefits

• Major medical, dental, vision insurance for temporary assignments lasting 13 weeks or longer.
• 401k plan and any statutory sick pay where required.