Healthcare Customer Service Representative

Title: Customer Service RepresentativeLocation: East Park Drive, Harrisburg, PA 17111Duration: 4-5 MonthsPay Rate: $17.20/hr on W2Summary of Duties:The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization's services to meet productivity and quality standards.Job Description:Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxesReceives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround timesResponds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating proceduresInteracts with hospitals, physicians, beneficiaries, or other program recipientsInvestigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate partyMeets or exceeds standards for call volume and service level per department guidelinesInitiates files by collecting and entering demographic, provider, and procedure information into the systemServes as liaison between the Review Supervisors and external providersMaintains logs and documents disposition of incoming and outgoing callsRequired Qualifications:High School diploma or equivalent2+ year's customer service/telephone experience in a similar call center environment and/or industry.Must have ability to effectively communicate with team members and external customersMust have ability to research and resolve issues related to Medicaid program and service eligibilityPreferred Qualifications:Previous experience in the medical office or other medical setting preferredGeneral knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)Knowledge of CPT and HCPCS codes preferredPC proficiency to include Microsoft Office SuiteExperience with Microsoft programs

Created: 2025-03-02