GENERAL SUMMARY
Responsible for servicing customers by processing billing inquiries or process Durable Medical Equipment requests, accurately and timely. Develops and enhances customer relationships as well as assists others to accomplish the same by responding to customer inquiries and resolving customer concerns accurately and efficiently and striving to exceed customer expectations in all contacts with them. Serves as a training resource and mentor.
ESSENTIAL RESPONSIBILITIES
- Interfaces with customers via telephone, fax and/or electronic mail to respond to inquires and resolve concerns, including those of a difficult and challenging nature. Takes responsibility for following through and bringing outstanding issues to closure. Assists with supervisory calls as necessary.
- Processes account receivable inquiries and/or electronic work queues accurately and efficiently including complex HCFA 1500 forms. Interprets and processes difficult adjustments in accordance with company policies and procedures. Reviews basic pending claims to determine the appropriateness of the claim status and takes necessary action based on status.
- Researches customer inquiries and information by effectively using on-line resource libraries to gather information needed to process the application or customer request or to assemble the documentation needed to process claims and adjustments and in response to inquiries including,but not limited to payments and equipment requests. Readily assesses and applies information to various customer situations.
- Investigates, analyzes and resolves outstanding issues to achieve customer satisfaction; uses a systematic approach in solving problems for enrollment, equipment needs or billing questions through analysis and evaluation of information and alternate solutions.
- Anticipates and quickly identifies customer needs. Acts independently and manages own activities with minimal supervision and direction to meet customer needs using sound decision making. Uses good judgment and logic in evaluating and resolving difficult enrollment, accounts receivable or claims issues.
- Demonstrates full understanding of all products, especially CWCS, DME and DME +
- Maintains phone and enrollment, accounts receivable or claims quality, and performance levels while working on customerrelated and other special projects.
- Serves as a training resource and mentor to others, particularly new hires. Shares best practices.
- Continuously seeks avenues for developing professional expertise and actively pursues new learning opportunities, which support the company's goals and objectives.
- Promotes a positive team environment; acknowledges others' contributions and provides feedback to team members.
- Encourages others to demonstrate professionalism and present a positive image of the company when interacting with customers.
- Performs other duties as requiredQualifications:
JOB SPECIFICATIONS
- High school degree or equivalent.
- 1-2 years Contact Center customer service or enrollment, accounts receivable or claims processing experience.
- Knowledge of medical termionlogy is preferred.
- Experience with medical billing and coding is preferred.
- Able to effectively handle multiple tasks.
- Demonstrates effective keyboard skills; ability to navigate within a computer/systems-dependent environment without assistance; experience in a windows-based computer environment .
- Excellent verbal and written communication skills.
- Displays a positive, confident attitude; highly self-motivated and accountable.
- Able to absorb and apply new and changing information.
- Able to quickly think on one's feet.
- Responds positively to goal-setting and performance measurement.
- Able to manage personal stress; can remain calm and controlled in stressful, unexpected situations; can easily adapt and effectively respond to shifts in priorities and unexpected events.
- Able to provide constructive feedback and serve as a mentor.
- Strong analytical and problem solving skills.
- Independent decision-making skills.
- Strong listening and interpersonal skills; skilled at developing and maintaining effective working relationships.
- Excellent organizational and time management skills.
- Able to sit for long periods of time.
- Able to maintain regular and consistent attendance in accordance with company and departmental policies and procedures.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team
Job: Administrative Support Workers
Primary Location: Tucson, AZ, US
Organization: 43007 - First Script Network Services
Schedule: Full-time
Job Posting: 2013-02-04 00:00:00.0
Job ID: 1310036