Healthcare Customer Service Consultant

Company Description

About Sutherland

Artificial Intelligence. Automation.Cloud engineering. Advanced analytics.For business leaders, these are key factors of success. For us, they’re our core expertise.

We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence.

We’ve created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless “as a service” model.

For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA.We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new possibilities, transformative outcomes and enduring relationships.

Sutherland

Unlocking digital performance. Delivering measurable results.

Job Description

We're Sutherland, and we are seeking attentive, goal-oriented individuals to support the expanding needs of one of our largest health insurance company customers. In this role, you will be responsible for the following:

• Delivering an exceptional customer experience by responding to incoming calls from Members with Medicaid Insurance to assist with simple and complex inquiries
• In times of high call volumes, phone calls may be received back-to-back with an “All Hands-on Deck” approach
  
  

Duties & Responsibilities

• Billing Inquiries & Complaints
• Authorizations
• Status Inquiries
• Utilization Management Inquiries
  
  

Eligibility And Benefits

• Status Inquiries
• Interpreting Medical Benefit Grids
• Updating Primary Care Physicians
• Assisting Members to Find Appropriate Doctors / Specialists
• Motive Care / Transportation Inquiries
  
  

Documentation

• Member Inquiries & Specific Details
• Updating Newborn Child Information
• Information provided on the phone call
• Routing Pathways
• Self-Service Option
  
  

Qualifications

Required Qualifications

• High School Diploma or equivalent
• 1-2 years of experience working in a high-volume call center environment as a customer service representative
• Effective verbal and written communication skills
• Strong typing and analytical abilities
• 35-40 words per minute typing
• Active listening and problem-solving abilities
• Soft skills and a positive attitude
• Multi-tasking skills with a strong attention to detail
• Sufficient Internet speeds while connected to a Remote Desktop Session (10MB Download / 2MB Upload)
• Ability to adhere to a mandatory script for call flow
• Effective communication in a virtual chat environment
• Time Management skills
• Quiet and distraction-free dedicated workspace
• Schedule adherence – Be present and on-time
  
  

Preferred Qualifications

• 1-2 years of experience in a medical office setting
• 1-2 years of experience with healthcare insurance
• Medicaid experience highly favored
• 1-2 years of experience with billing or coding
• 1-2 years of experience with back-end processing
  
  

IMPORTANT NOTE: This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.

Additional Information

About Us

Sutherland, recently recognized as a Great Place to Work in the US, is a digital transformation company, making digital processes feel more human for the customers that we serve. We have been helping customers globally, across industries from financial services to healthcare, entertainment to retail, insurance to gaming, and everything in between, provide exceptional experiences for their customers for over 35 years.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.