Customer Service Representatives/Healthcare Hospital-Remote

Company Description

Do you enjoy helping others, answering questions and resolving problems? Do you have any experience in the healthcare/medical field or are you interested in pursuing a career in the field? Are you looking for an opportunity to build a fulfilling career while working from home?

Join Us.

Job Description

We're Sutherland, and we are seeking attentive, goal-oriented individuals to support the expanding needs of one of our largest health insurance company customers.
In this role, you will need to be able to:

• Deliver an exceptional customer experience by responding to incoming calls from both in-network and out-of-network providers to assist with simple and complex inquiries
• In times of high call volumes, receive back-to-back calls with an “All Hands on Deck” approach
• Adhere to your assigned schedule - Monday-Friday, 8AM-5PM EST
• Provide a quiet and distraction-free dedicated workspace

Duties & Responsibilities;

• Assist providers with claims and claims investigations
  • Status Inquiries
  • Denial Rationale
  • Appeals
  • Research and Routing
  • Explanation of Payments / Explanation of Benefits Requests
• Authorizations
  • Status Inquiries
  • Denial Rationale
  • Utilization Management Appeals
  • Prior Authorization Verification
• Eligibility and Benefits
  • Status Inquiries
  • Interpreting Medical Benefit Grids
  • Verification of Provider Participation
  • Credentialing Inquiries
• Documentation
  • Provider Inquiries & Specific Details
  •  Outcome of the Call and Next Steps/Resolution
• Self-Service Options
  • Assisting providers with education on available Self-Service Options
  • Walk Providers through Availity

When you join us, you’ll enjoy;

• Competitive pay rate of $16/hour
• Medical, dental and vision benefits
• Paid training
• Global Flexible Vacation Policy after training
• Company-provided equipment
• Advancement opportunities – 80% of our frontline leaders have been promoted from within
• Monthly rewards & recognition programs
• Employee Discounts
• EAP & Health and Wellness programs including a personal trainer dedicated to Sutherland
• Weekday schedule, Monday-Friday, 8AM-5PM EST
   

Qualifications

Required Qualifications

• High School Diploma or equivalent
• 1-2 years of experience working in a high-volume call center environment as a customer service representative
• Effective verbal and written communication skills
• Strong typing and analytical abilities
  • 40 Words-Per-Minute typing-speed
• Active listening and problem-solving abilities
• Soft skills and positive attitude
• Multi-tasking skills with a strong attention to detail
• Time Management skills
• Sufficient Internet speeds while connected to a Remote Desktop Session (10MB Download / 2MB Upload)

Preferred Qualifications

• 1-2 years of experience in a medical office setting
• 1-2 years of experience with healthcare insurance
• 1-2 years of experience with billing or coding
• 1-2 years of experience with back-end processing

IMPORTANT NOTE: This job is open only to …