Call Center Representative

About the role

This is a call center role with metrics needed. Call Center experience is preferred. Some medical billing or insurance is very helpful. Paid training is provided. We are looking for people who are seeking long term careers. This is a possible temp to perm role.

Responsibilities

• To verify new patient insurance coverage and to re-verify existing patient insurance coverage for medical supply eligibility and billing purposes
• Verification and documentation of new patient insurance coverage and coordinating costs for supplies in order to communicate to the patient and billing what the patient order cost will be
• Re-verification of existing patient insurance coverage to ensure that repeat order cost and eligibility is communicated to the patient and the billing department
• Contact insurance carriers to request any prior authorizations as needed for patients that must seek prior approval before obtaining medical supplies
• Special verification projects for newly contracted insurance plans and audit of any patients that may be impacted
• Verification of insurance coverage through HIPAA and regulatory complaint out bound phone calls or via the providers online portal
• Communication internally with Sales operations or Medical Billing operations of insurance eligibility for each new and existing patient in order to complete the sale or obtain further medical documentation
• Communication externally with patients to explain information received relative to their insurance benefit and how it relates to their medical supply purchase
• Develops and maintains knowledge in medical terminology, billing and insurance guidelines
• Able to identify and professionally resolve insurance verification related issues
• Track daily production and submit daily log to direct supervisor.

Qualifications

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Education/Experience: High School Diploma or general education degree (GED); One to two years related experience and/or training; or equivalent combination of education and experience.
• Skills: Language: Ability to read, analyze, and interpret medical supply publications, technical procedures, and/or training tools. Ability to write internal and external business correspondence. Math: Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Reasoning: Ability to solve practical problems and deal with a variety of variables. Computer: Knowledge of Microsoft Office Applications, Access or other database software. Telecommunications: ability to utilize or knowledge of call center telecommunications software. Licensure or Certifications required: No certifications required

Benefits

Production/Quality Metrics: Demonstrate ability to produce one (1) completed insurance verification every 9-11 minutes on average, with an error rate of 3.5% or less each calendar quarter.