What are the responsibilities and job description for the Call Center Representative position at TIMESSQUARETECH NYC INC?
Responsibilities:- Performs review of service requests for completeness of information, collection and transfer of non-clinical data, and acquisition of structured clinical data from physicians/patients.- Handles initial screening for pre-certification requests from physicians/members via incoming calls or correspondence based on scripts and workflows, and under the oversight of clinical staff.- Prepare, document and route cases in appropriate system for clinical review.- Initiates call backs and correspondence to members and providers to coordinate and clarify benefits.- Upon completion of inquiries initiate call back or correspondence to Physicians/Members to coordinate/clarify case completion.- Reviewing professional medical/claim policy related issues or claims in pending status.- Upon collection of clinical and non-clinical information MCC can authorize services based upon scripts or algorithms used for pre-review screening. *Non Clinical staff members are not responsible for conducting any UM review activities that require interpretation of clinical information.- Perform other relevant tasks as assigned by Management.
Core Individual Contributor Competencies: Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus Accountable Learn Communicate
Job Type: Contract
Pay: $16.00 - $18.00 per hour
Expected hours: 40 per week
Education:
- High school or equivalent (Required)
Experience:
- customer service: 2 years (Required)
- medical terminology: 1 year (Required)
Work Location: In person
Salary : $16 - $18
