Customer Service Representative - Remote

  • 99 Troy Rd, East Greenbush, NY 12061, USA
  • Employees can work remotely
  • Full-time

Company Description

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 We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach.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.

Job Description

  • Conducts administrative intake and scripted clinical intake of calls for clinical review
  • Provides quality customer service through interaction with providers, administrative staff and others
  • Builds and maintains customer satisfaction with products and services; provides excellent service to internal and external customers
  • Collects and enters confidential information ensuring the highest level of confidentiality in all areas
  • Maintains high-quality documentation standards when collecting and performing data entry functions
  • Provides ongoing telephonic support to providers and office staff related to HealthHelp’s Clinical Review process
  • Provides administrative support to the Clinical Review Department if needed
  • Participates and understands scope of responsibility pertaining to ongoing Quality Initiative Projects
  • Maintains acceptable levels of performance for all Key Performance Indicators, such as Average Talk Time (ATT), Quality, and adherence to schedule
  • 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 in keeping with HealthHelp’s compliance initiatives
  • Carries out other projects and responsibilities as assigned

Qualifications

  • High School Diploma/GED, required
  • Associates Degree preferred
  • Prior experience in the healthcare industry (i.e., prior authorizations, patient care, CPT codes, etc.) is desirable
  • Ability to read clinical terminology with high levels of proficiency
  • At least one year of Contact Center experience; within the healthcare industry preferred
  • Ability to work efficiently in a fast pace, high call volume, performance driven Contact Center
  • MS Outlook and Windows proficiency
  • Ability to work on dual monitors and navigate multiple software applications simultaneously
  • Strong time management skills
  • Ability to adhere to strict schedule with ability to adapt to schedule changes
  • Highly skilled at delivering client and customer satisfaction
  • Must possess strong verbal and written communication skills

Additional Information

All your information will be kept confidential according to EEO guidelines.

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