Healthcare Customer Service Specialist II

As a Healthcare Customer Service Specialist, you will:

• Take inbound calls from providers to answer questions and resolve complex issues.
• Make outbound calls to healthcare providers to confirm if letters requesting records for review have been received.
• Respond to assigned written communications from providers timely and accurately.

You will also:

• Educate providers on proper process protocols and their appeal rights.
• Establish appropriate contacts and perform necessary research to validate provider contact information.
• Enter and update all contact and activity information into tracking logs and the audit platform.

And:

• Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry.
• Research and route internal/external communications to the appropriate person or department.
• Notify management of escalated issues, legal action, government intervention, or suggestions to improve processes.