Customer Service Representative (Remote)

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Customer Service Representative to join our growing team.

Job Summary:

The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints and requests adhering to internal policies and procedures and utilizing working knowledge of the organization’s services to meet productivity and quality standards. 

*This position is remote*

Job Responsibilities:

• Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilizes automated systems to log and retrieve information. Performs accurate and timely data entry of electronic faxes
• Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
• Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
• Interacts with hospitals, physicians, beneficiaries, or other program recipients
• Investigates and resolves or reports customer problems. Identifies and escalates difficult situations to the appropriate party
• Meets or exceeds standards for call volume and service level per department guidelines
• Initiates files by collecting and entering demographic, provider, and procedure information into the system
• Serves as liaison between the Review Supervisors and external providers
• Maintains logs and documents disposition of incoming and outgoing calls

Requirements

• High School diploma or equivalent
• 2+ year’s customer service/telephone experience in a similar call center environment and/or industry.
• Must have ability to effectively communicate with team members and external customers
• Must have ability to research and resolve issues related to Medicaid program and service eligibility
• Bilingual (Spanish/English)

Preferred Qualifications/Experience:

• Previous experience in the medical office or other medical …