Customer Service Representative - CSR - Talencia LLC

Position: Customer Service Representative
Facility: MDwise
Address: 2955 N Meridian St Suite 201, Indianapolis, IN 46208
Duration: 13 Weeks
Shift: 8 Hours/Days
Pay: $22/Hour W2


Remote with onsite/virtual training. Work from home position after training completion

Position Summary:

This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services. Also may be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.

Essential Functions and Responsibilities:

1. Meet the Department standard of calls answered, and call documentation entered.

2. Assist Members and Providers with questions and concerns.

Finding Provider(s)/Services for members

Arrange Transportation for members

Answer billing/claims status questions; resolve claim issues for members

Assist with pharmacy issues

Help Members access community support services

Verify member eligibility

Quote benefits

Assist with Referrals

Assist with member health assessments

Assist members with closing gaps in care

3. Ongoing member education.

4. Responsible for all benefits information given to Members and Providers.

5. Participate in Departmental Projects, as appropriate.

6. Coordinate quality improvement initiatives with Medical Management, Provider Relations, and Quality Depts., i.e., Preventative Health Screenings.

7. Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.

REQUIREMENTS