VBC Customer Services Representative II - Remote

JOB SUMMARY 

Responsible for answering incoming calls from providers, health plan and members as they relate to eligibility, benefits, claims, coverage, and authorization of services. This position supports multiple lines of business and will also problem-solve and explain programs and procedures to callers and will answer/address claim payment questions with providers. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Answering incoming phone calls via ACD phone system
• Entering of telephonic referrals 
• Provide eligibility, benefits, claim, and referral status depending on the queue on which they serve
• Retrieve Voice Mails
• Assist in resolving issues for providers as they relate to claims, authorization, and eligibility inquiries
• Serves as resource to CSRI 
• Special projects as assigned
• Able and willing to step in, in the absence of the lead and or supervisor to lead the team.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• A strong sense of responsibility for providing a great customer experience
• Detail-oriented and highly organized
• Leadership skills 
• Excellent verbal and written communication skills.
• Excellent organization skills with ability to handle multiple tasks and prioritize work.
• Knowledge of CPT, ICD-10, HCPCS codes, HCFA1500 and UB04 billing forms.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

• 2-3 years of customer service experience in a call center and or health care environment preferred
• High school degree or equivalent required, bachelor’s degree preferred

PHYSICAL DEMANDS 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.            

• Must be able to work in sitting …