Customer Service Representative

Company Name:
McLaren Regional Medical Center
Post Date 3/21/2014
Title Customer Service Representative
Job Family Administrative/Clerical
Subsidiary McLaren Health Plan
Department 92251 - Customer Service
Location Flint Region
City Flint
State MI
Full Time Yes
Hours per 2 week pay period 80
Schedule Standard Business Hours, 8:30am - 5:00pm
Weekends and/or Holidays Required No
On Call Required No
McLaren Health Plan, recognized by Modern Health Care as one of the 100 Best Places to work for four years in a row, is seeking a Customer Service Representative to join our Customer Service team!
This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services. Also responsible for assisting providers with eligibility, benefit, and resolution of claims issues.
High School Diploma or equivalent certification
Two (2) years experience in a high volume call center
Experience in a high paced physician office environment
Understanding of HMO and health plans
Ability to handle multiple projects simultaneously
Excellent analytical and problem solving skills
Excellent communication, consultancy, facilitation and conflict resolution skills and present self to people in a courteous, tactful and poised manner
Strong relationship building skills and the ability to influence others positively
Proven data entry skills with an Alpha/Numeric score of 4500 KPH or more
Computer skills including command of Word, Excel, and email required
Available to work a flexible schedule to meet organizational needs
In-depth understanding of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.
Associate s Degree in business, health care or related field. An equivalent combination of relevant education and experience may be substituted for the educational requirement
Two (2) years experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts)
Minimum: $12.29
Maximum: $17.46
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