Healthcare Customer Service Rep Remote

Start a rewarding career in healthcare at Imagenet!

Do you have a passion for helping others and making a positive impact on their lives? Are you looking for a challenging and rewarding career in the healthcare industry? If so, Imagenet is seeking exceptional Customer Service Advocates to join our team.

About the Role:

Join our team as a Customer Service Advocate, where you will play a crucial role in taking member services calls in relation to policy management, benefits and claim inquiries. You will be a valued member of the team, providing exceptional customer service to our clients and members by ensuring their satisfaction on calls. As a key contributor, you will be responsible for accurately and efficiently reading and relaying information to members. This position requires a solid understanding of the health care claims, benefits and policy process flows and expertise in healthcare terminology, including ICD-9 and ICD-10 coding.

Remote Position located in GA, KY, IN, MO, NC, OH, PA, TN, TX, UT

Job Type: Full Time - 100% Remote Position

Salary: $17.00 to $18.00 per hour

Monday -Friday 9:00am to 9pm EST - you will be assigned a set schedule within this timeframe after training

What We Offer: 

• Genuine work/life balance - a predictable schedule
• Paid training period 
• Medical, Dental, Life, Vision, HSA, 401K
• PTO

Key Responsibilities:

• Member and Provider Support: Manage inbound and outbound calls, responding to member and provider inquiries with professionalism and accuracy. Provide information on membership options, benefits, and account status on behalf of our clients.
• Application Processing: Review, verify, and process membership applications efficiently, ensuring completeness and accuracy of all required information.
• Data Entry and Management: Maintain and update member information in our CRM systems, ensuring data integrity and accuracy across multiple client accounts.
• Multitasking: Handle multiple client accounts and responsibilities simultaneously, managing calls, processing paperwork, and updating databases without compromising on quality.
• Quality Assurance: Perform regular audits of member data to ensure compliance with client standards and industry regulations, identifying and rectifying any discrepancies.
• Collaboration: Coordinate with other teams within ImageNet, including IT, customer service, and quality assurance, to resolve issues and enhance service delivery for our clients.
• Process Improvement: Continuously identify opportunities to streamline processes and contribute to initiatives that improve client satisfaction and operational efficiency.

Job Description:

Handle Inbound Calls:

• Receive and respond to calls primarily from members, providers, and occasionally other health plans.
• Provide information on the status of authorization requests, including both inpatient and outpatient services.

Authorization Management:

• Address and manage re-direct requests.
• Handle requests to re-fax authorization documents as needed.

Extensive Claims Denial: 

• Deep understanding and description of claims and claims denials.

Lines of Business:

• General Membership, Health Plan Providers, ETC.

Documentation and Compliance:

• Accurately document call interactions and outcomes in the appropriate systems.
• Ensure compliance with all relevant regulations and guidelines.

Customer Service:

• Maintain a high level of professionalism and customer service in all interactions.
• Resolve issues promptly and effectively, ensuring customer satisfaction.

Qualifications:

• Educational Background: High school diploma or equivalent

• Technical Skills:
  • Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
  • Experience with CRM systems or membership databases.
  • Strong typing and data entry skills, with the ability to manage multiple systems simultaneously.

Other Qualifications:

• Attention to Detail: Keen ability to detect and correct errors in data, ensuring high standards of accuracy and consistency.
• Multitasking Ability: Proven track record of effectively managing multiple tasks and priorities in a busy work environment.
• Communication Skills: Excellent verbal and written communication skills, with the ability to articulate information clearly and confidently to members.
• Problem-Solving Skills: Strong analytical capabilities with a focus on identifying issues and implementing solutions quickly and effectively.
• Customer Service Orientation: A passion for delivering exceptional service to clients and their members, aligning with ImageNet’s commitment to excellence.

COMPANY OVERVIEW

 Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers. 

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers.  The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.  The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

Imagenet LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.