Job Summary:
This role involves providing prompt accurate and courteous resolution of member provider and health plan issues. The Customer Service Representative promotes favorable relationships through efficient handling of tasks such as authorization processing claim research coordinating translation services and Primary Care Provider changes. The position requires knowledge of medical terminology and proficiency in various computer applications.
Location: San Diego California United States
Responsibilities:
- Process authorizations accurately and efficiently.
- Research and resolve claims issues.
- Coordinate translation services as needed.
- Manage Primary Care Provider changes.
- Respond to member provider and health plan inquiries.
- Maintain accurate records and documentation.
- Utilize computer systems for data entry and information retrieval.
- Collaborate with other team members to ensure efficient workflow.
- Promote positive relationships with all stakeholders.
Required Skills & Certifications:
- One year of experience as a Customer Service Representative in a healthcare setting (Bachelors degree considered in lieu of experience).
- Knowledge of medical terminology (ICD-10 CPT HCPC codes).
- Proficiency in Excel Word Outlook and data entry systems.
Preferred Skills & Certifications:
- Bachelors degree.
Special Considerations:
- On-site position.
- Consistent work history required (no large gaps).
- Two positions available with separate start dates (August 11th and August 25th).
- Interviews are conducted on-site.
Scheduling:
- Monday-Friday 8:30 AM - 5:00 PM PST.