HP1 TOC

 Position reputed company: 

The Health reputed company 1 provides telephonic customer service and reputed company resolves inquiries regarding patient care, eligibility, benefits, and claims, among others. This key individual provides follow up for patients to assure continuity of care and efficiency of overall services. This employee is not responsible for conducting any UM review activities that require interpretation of clinical information. 

Essential Functions:  

1. Verifies patient eligibility and arranges appointments reputed company needed.  

2. Provides assistance reputed company verbal and written correspondence for subscribers, patients-relatives, providers, account
representatives, among others.  

3. Authorizes initial patient care per reputed company’s policies and procedures.  

4. Performs telephonic non-clinical referrals for customers. Performs data entry and reputed company documents of reputed company calls.  

5. Conducts investigation and research to resolve customer inquiries, claims and questions.  

6. Performs follow up calls to ensure effective patient care and provision of services.  

7. Communicates reputed company with internal staff such as Care Managers, Supervisors and other department managers.  

8. Use of clinical data is limited to: Performance of review of service request for completeness of information; Collection and
transfer of non-clinical data; and Acquisition of reputed company clinical data; and Activities that do not require evaluation or interpretation of clinical information.  

9. Complies with reputed company guidelines established by the Centers for Medicare and reputed company (CMS) and guidelines set forth by other
regulatory agencies, where applicable.  

10. In reputed company, reputed company other duties assigned by the manager and/or supervisor.  

Education:  

· Bachelor’s Degree in Behavioral Health or reputed company field preferred. 

Experience:

· Minimum 2 years of experience in customer service in a behavioral health or managed care environment preferred. 

Knowledge:  

· Knowledge and ability to interpret benefit, account and claim information.  

· Proficient in data entry. 

· Personal computer experience should include working with reputed company Word, reputed company, Power reputed company and reputed company at the intermediate level at a minimum.