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Concentrix Insurance Client Advocate I, CIS in Greenville, South Carolina

Job Title:

Insurance Client Advocate I, CIS

Job Description

This position is responsible for providing excellent customer service, responding to customer inquiries, including reimbursement processing, order placement, shipping status, warranty and general concerns. Assists with benefits investigation and answers a variety of reimbursement related questions. Strong communication between patients, physicians, healthcare and insurance providers are critical functions of this position.

The Customer Care Specialist is able to independently follow standardized workflows as defined by the organization. Customer service experience is required, reimbursement/insurance and healthcare experience is preferred. The Customer Care Specialist is not only responsible for ensuring a positive customer interaction, but will also ensure that benefits/coverage, prior authorization and documentation is correctly obtained which will allow the client to be successfully.

Responsibilities

o Using their advanced knowledge and skill set, this position could be called upon to complete a wide range of task within the Reimbursement team.

 Collaborate with other commercial teams such as Case Management, OmniPod Sales and Billing, to ensure proactive communication of potential customer’s order status.

 Calculate and document cost share amounts for potential customers.

 Submission of all prior authorization requestsInsulet for approval and payment of the clients products at time of claim processing.

 Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.

 Serving as a department expert on all client insurance contracts, channeling and processing requirements for all covered products.

 Provide frequent feedback and suggestions to support an environment of continuous process improvement.

 Responsible for maintaining satisfactory call and order counts as defined by management.

 Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.

 Work as part of the larger support team, collaborating with other departments to ensure proactive, superior front-line customer support.

 Answering phone inquiries and providing support and direction to customers and resolving customer service issues in a timely and empathetic manner.

 Understand the clients channeling and processing requirements for all covered products, which is based on medical policy and payer guidelines.

 Must maintain a thorough understanding of products offered by the client with the ability to explain to potential or existing customers the basic operation and use.

 Requesting and collecting updated documentation, prior authorizations, order entry and coordinating shipment of product to customers.

 Process all aspects of the order process by verifying insurance benefits/coverage to determine eligibility and calculate cost share amounts for existing and new customers.

This position is responsible for providing excellent customer service, responding to customer inquiries, including reimbursement processing, order placement, shipping status, warranty and general concerns. Assists with benefits investigation and answers a variety of reimbursement related questions. Strong communication between patients, physicians, healthcare and insurance providers are critical functions of this position.

The Customer Care Specialist is able to independently follow standardized workflows as defined by the organization. Customer service experience is required, reimbursement/insurance and healthcare experience is preferred. The Customer Care Specialist is not only responsible for ensuring a positive customer interaction, but will also ensure that benefits/coverage, prior authorization and documentation is correctly obtained which will allow the client to be successfully.

Responsibilities

  • Using their advanced knowledge and skill set, this position could be called upon to complete a wide range of task within the Reimbursement team.

  • Collaborate with other commercial teams such as Case Management, OmniPod Sales and Billing, to ensure proactive communication of potential customer’s order status.

  • Calculate and document cost share amounts for potential customers.

  • Submission of all prior authorization requestsInsulet for approval and payment of the clients products at time of claim processing.

  • Process all aspects of reimbursement by contacting payors, verifying insurance benefits and adhering to medical guidelines for reimbursement.

  • Serving as a department expert on all client insurance contracts, channeling and processing requirements for all covered products.

  • Provide frequent feedback and suggestions to support an environment of continuous process improvement.

  • Responsible for maintaining satisfactory call and order counts as defined by management.

  • Document all interactions and calls into the customer database and maintain compliance to HIPAA and other regulating bodies as required.

  • Work as part of the larger support team, collaborating with other departments to ensure proactive, superior front-line customer support.

  • Answering phone inquiries and providing support and direction to customers and resolving customer service issues in a timely and empathetic manner.

  • Understand the clients channeling and processing requirements for all covered products, which is based on medical policy and payer guidelines.

  • Must maintain a thorough understanding of products offered by the client with the ability to explain to potential or existing customers the basic operation and use.

  • Requesting and collecting updated documentation, prior authorizations, order entry and coordinating shipment of product to customers.

  • Process all aspects of the order process by verifying insurance benefits/coverage to determine eligibility and calculate cost share amounts for existing and new customers.

  • #NACNX

  • *msja

Location:

USA Greenville SC - 2000 Wade Hampton - Genelco

Language Requirements:

English

Time Type:

Full time

Mission:

We will be the greatest customer engagement services company in the world, rich in diversity and talent. We will get there by embracing our culture.

About Concentrix:

We’re a company like no other. We are fanatical about our staff and are constantly helping them grow and achieve their career goals. We are a global workplace that offers YOU infinite possibilities!

Company Overview:

In a world full of average, we stand out. We believe experience is everything. Period. To achieve outstanding results, we’re disrupting the market by being absolutely obsessed with making our clients’ businesses better. We bring together the brightest and most creative minds in business, cutting-edge technology solutions, proven design thinking expertise and exceptional customer experience centers. Our clients notice the difference too… in increased customer loyalty, improved business performance and differentiation in their markets. As a diverse, global organization, we have unconventionally fresh ideas and deliver extraordinary customer experiences for more than 450 of the world’s best brands. Concentrix. A passionate company powered by passionate people.

Concentrix CVG Corporation is an EEO/AA/M/F/Vet/Disability Employer.

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