Customer Service Representative,
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 (Bachelor's 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:
- Bachelor's 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.
Recommended Jobs
Line Cook
The hiring rate for this position is $21.00. Please apply to learn more about the benefits of working for the CIA. POSITION SUMMARY The Line Cook is responsible for working in conjunction…
In-Office VBC Coordinator, Medicare Population Health Programs
DESCRIPTION We are building a new care delivery capability within our Senior Health clinics to support high-value, comprehensive primary care. As an In-Office Senior VBC Coordinator, you’ll suppor…
Enforcement Analyst
Job Description and Duties If this is a limited term position, it may be extended up to 24 months and/or become permanent. If this is a part-time or intermittent position, the time base may be inc…
Team Lead - Senior Subcontract Administrator (Spec)
Job Posting End Date: Until Filled Shift: 1st Security Clearance: No Clearance SUMMARY The primary purpose of this position is to perform highly-advanced SCM tasks and/or proj…
Dana Pool Food Runner
**Additional Information** Pay: $17.50/hour, full time, temporary **Job Number** 25121669 **Job Category** Food and Beverage & Culinary **Location** The Ritz-Carlton Laguna Niguel, One Ritz Carlton Dr…
Server/Dishwasher
Ready to Join a winning team? At Carefield Pleasanton Memory Care, we value individuality and strong team connectivity. Our team members are compassionate, dedicated, and committed to providing high…
.Net Azure Lead
Job Role: .Net Azure Lead Duration: Long Term Contract Hands-on Senior developer with at least 15 years of experience in .NET and having solid coding skills using of .NET core 6/7 Good know…
Delivery Driver - 708 W. 11th St.
Job Description DRIVER Deliver orders to guest locations Able to count change back to guest Give great guest service at the door Help take orders inside location when needed Abl…
Revenue Accounting Manager
Job Description Job Description You could be an accounting manager anywhere. Why Jerry.ai? Join a pre-IPO startup with capital, traction and runway ($240M funded | 60X revenue growth in 5 years…
Radiation Therapist in Los Gatos CA
Job Summary: - Shift/Schedule: Day shift, 8 hours per day, 8:00am-4:30pm - Experience Required: At least 1 year of experience - First-timers Accepted: Yes - Certifications Re…