Client Service Representative
- 5959 Corporate Dr, Houston, TX 77036, USA
HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.
HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.
Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.
WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.
Conducts administrative intake and scripted clinical intake of calls for clinical review
Provides quality customer service through interaction with providers, administrative staff and others
Collects and enters confidential information ensuring the highest level of confidentiality in all areas
Escalates all calls to a Clinical Reviewer or Supervisor per guidelines
Maintains written documentation according to HealthHelp”s documentation policy
Provides ongoing telephonic support to providers and office staff related to HealthHelp’s Clinical Review process
Assists in the orientation and training of new Client Service Representatives in department procedures, protocols, and administrative tasks
Provides administrative support to the Clinical Review Department if needed
Carries out other projects and responsibilities as assigned
Participates and understands scope of responsibility pertaining to ongoing QI Projects
Maintains acceptable levels of performance for all KPIs
Participates in the HealthHelp Quality Management Program as required
Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
Adheres to both URAC & NCQA standards pertinent to their job description
Proficiency with medical terminology desirable
MS Outlook and Windows proficiency
High School Diploma
Associates Degree (preferred)
Medical assistant or other clinical or medical office experience desirable
Or at least one year of Call Center experience
At least 1 year of Customer Service experience
Highly skilled at delivering client and customer satisfaction
Must Possess strong verbal and written communication skills
Ability to read and comprehend complex documents