|
« Previous Job | Next Job » |
|
| |
| Company: |
Universal American Corporation |
Location: |
Houston - General |
| Salary: |
|
Experience: |
Unspecified |
| Status: |
Full Time |
Career Level: |
Experienced (Non-Manager) |
| Category: |
Customer Service |
Phone: |
|
| |
| Contact: |
|
|
| |
|
|
Provider Customer Service Representative
Tracking Code
304202-763
Job Description
The Provider Customer Service Representative will be responsible for handling incoming calls from members and resolving a member issues within a timely, accurate, and courteous manner. The PCSR will have a thorough understanding of the Health Plan’s member Evidence of Coverage (EOC), the Member Summary of Benefits, and an excellent understanding of Medicare and Medicaid. 1. A member contacts PCSR to handle and resolve Health Plan issues. 2. PCSR documents reasons for call and what was done to resolve callers’ concern(s). 3. Maintains a close working relationship with other departments to initiate communication and to confirm information if there is a question regarding authorization, benefits, eligibility, claims, etc. 4. Preparation of PCSR may be required. Reports should include volume of calls coming in, type of calls, and a summary of trends that the Member Service staff is handling. In addition, keeps Manager updated on potential problems on a daily basis. 5. PCSR has knowledge of Health Plan policies and procedures. PCSR will demonstrate an active interest in improving current level of skill and knowledge by regularly reviewing Policy and Procedure manuals. 6. PCSR will promote teamwork within department and emphasizes the need for excellent Member service by respecting co-workers time and circumstances and dealing with all Health Plan employees in a friendly, respectful manner. 7. PCSR will be proficient with Health Plan systems. The PCSR will be trained on the Health Plan’s systems and maintain proficiency. 8. PCSR has in depth knowledge and understanding of Health Plan EOC. 9. PCSR will consider all patients, Health Plans, and contract terms received as confidential PHI. 10. PCSR performs other duties and special projects as assigned.
Required Skills
Must possess excellent verbal and written communication skills. Prefers five or more year’s health care managed care and/or Medicaid experience. . Must have the ability to interact professionally and effectively with members, providers, physicians, and staff from all departments within the Health Plan. Must be willing to work a flexible schedule.
Required Experience
Minimum experience in call center three (3) years. Some knowledge in Managed Care, Medicare, and Medicaid plan terms and CMS regulations preferred
Job Location
Houston, TX, US.
Position Type
Full-Time/Regular
|
| |
Tell them you found this job on MyOnlineTown.com |
|
|
|
|
© 2010 MyOnlineTown |
About Us |
Contact Us |
Terms of Service |
Privacy Policy
|
