Customer Service Representative 1 - Acentra Health

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 1 to join our growing team.

Job Summary:

This Customer Service Representative is a front-line service position aiding Wyoming Benefits Management System and Services (WY BMS) members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities also include the administration of intake documentation into the appropriate systems. Overall expectations are to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call. Performance expectations are to meet or exceed operations production and quality standards. This position is located in Cheyenne, Wyoming.  

Job Responsibilities: 

• Available to work an 8 hour shift from 7:00 AM to 6:00 PM Mountain Time on all State business days, Monday through Friday (excluding Wyoming State holidays).
• Accurately respond to inbound phone calls and processing provider and member inquiries and requests into the appropriate system and database.
• Under general supervision resolve customers’ service or billing complaints by demonstrating sound judgement.
• Contact customers to respond to complex inquiries or to notify them of claim investigation results and any planned adjustments.
• Under general supervision resolve customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
• Refer unresolved customer grievances, appeals, and claim resolution to designated departments for further investigation.
• Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.
• Actively listens and probes callers in a professional and timely manner to determine purpose of the calls.
• Under general supervision research and articulately communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries to callers while maintaining confidentiality.
• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
• Educate providers on how to submit claims and when/where to submit a treatment plan.
• Under general supervision perform necessary follow-up tasks to ensure member or provider needs are completely met.
• Support team members and participate in team activities to help build a high-performance team.
• Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.
• Escalate calls to Call Center Lead when necessary.

Requirements

Required Qualifications/Experience: 

• High School graduate or GED.
• At least 1 year of customer service-related experience required.
• Previous experience with computer applications, such as Microsoft Word and PowerPoint.
• Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
• Must be able to maneuver through various computer platforms while verifying information on all calls.
• Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.

Preferred Qualifications/Experience: 

• Bilingual Spanish speaking
• Call center experience
• Healthcare industry experience
• Medicaid experience

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation

The pay range for this position is $12.00-$18.00.

Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.