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Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is focused on enhancing healthcare services and is seeking a Healthcare Customer Service Representative. In this role, you will assist clients by answering inquiries, implementing healthcare policies, and resolving provider issues while ensuring compliance with service level agreements.
Responsibilities
Answers telephones and responds to basic customer questions and/or forwards to appropriate personnel and provides consultancy utilizing knowledge and expertise on insurance and healthcare
Develops and implements general insurance and health care policies in accordance with state and federal laws and provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions
Responds to provider appeals and meets with providers to resolve problems/issues. Advises provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs
Processes calls in a manner that ensures service level agreements (SLAs) are met or exceeded. Records calls, processes requests and updates account history with results of inquiry to include proper documentation
Interfaces with team members, management, and customers in reference to customer service issues. Review and recommends modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions
Skills
2 or more years of customer service experience in any industry
Knowledge of basic help desk software, computer software and Microsoft Office applications
Strong problem-solving skills to bring inquiries to effective resolution
Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally
Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries
Benefits
Most benefits start on first day of employment
Remote (work from home)
All salaried, full-time candidates are eligible for our generous, flexible vacation policy
A 401(k) employer match
Comprehensive health benefits
Educational assistance
A variety of leadership and technical development academies to help build your skills and capabilities
Company Overview
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital. It was founded in 2009, and is headquartered in Irving, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.gainwelltechnologies.com/.
