Ajilon is working with a company located in Chandler, AZ searching for a Medical Customer Service Advocate. This position will entail The ideal candidate will have medical customer service background and knowledge of medical terminology. This position requires on site training and will be remote to start due to COVID, but will eventually transition back into office full time. This is a Monday-Friday shift paying $15.00-$17.00 per hour depending on experience.
Serve as an advocate for patients, to assist with inquiries regarding referrals and prior authorizations, provider network, appeals and grievance processes by addressing questions or concerns. Processes complaints and research issues; working with appropriate internal and external partners.
Respond to customer inquiries via telephone with focus on resolving issues on the first call by utilizing current reference materials and resources to identify the status of the issue and provide appropriate response to the caller.
Deliver information and answer questions in a positive, conversational and compassionate manner to facilitate developing a relationship with the caller, while providing the best customer service experience possible.
Provide assistance to health care professionals, vendors, the Health Plan; verify patient eligibility, provide status of claim payments, referrals/prior authorization status and route to the appropriate operational area for additional information.
Gather necessary, relevant information and complete documentation necessary to track issues and inquiries into Customer Service application.
Provide follow-up contact with patients and providers to assure satisfaction with resolution.
Assist members and/or providers regarding website information and navigation.
Identify trends related to incoming or outgoing calls to support excellent customer service, quality improvement, call reduction and issue resolution, escalating issues to management as deemed appropriate.
Consistently achieve performance goals established for the position in the areas of efficiency, call quality, provider satisfaction, first call resolution and attendance.
Perform other duties as assigned, including but not limited to special projects, outreach initiatives, administrative duties, receptionist desk support, etc.
- High school diploma or equivalent. Some college preferred.
- Prior experience in customer service.
- Knowledge of Medicare, managed care systems, and medical terminology preferred.
- Excellent written and oral communication skills.
- Ability to interact with providers and patient in a professional manner with a strong commitment to positively representing the company.
- Ability to function in a high stress environment.
- Familiarity with computer and Windows PC applications and the ability to multi-task and navigate a computer while on the phone
If you meet the above requirements, apply today and send a copy of your resume to firstname.lastname@example.org for quicker consideration.
Equal Opportunity Employer/Veterans/Disabled
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