Job Title: Customer Service III
Location: Orlando, FL – Onsite – Local candidates only
Period: 12/20/2024 to 05/02/2025 - possibility of extension/direct hire **
**Hours/Week: 40 hours (Hours over 40 will be paid at Time and a Half)
Rate: $20 - $22/hour
Contract Type: W-2

Scope of Services:

The Customer Service III position takes a high volume of inbound or places outbound calls to provide information and services to customers. A minimum of 1 year’s knowledge of VA, Workers Comp, PA Appeals is a must, as well as an understanding of Medicare rules and regulations, and managed care as it relates to benefits and authorizations. The position utilizes a database to retrieve customer or company information. Must be able to learn and follow detailed instructions, use a variety of resources and possess good organizational skills to provide accurate information. Follows processes and steps to ensure appropriate actions and follow through taken for customers. Document needs for customers in databases. Must demonstrate patience, tact, empathy and problem solving skills with consistently good voice quality. Can organize and handle calls with speed and accuracy. Must be able to be available to customers for a certain period of time during the day. Can work with complex computer applications and resource materials. Can use multiple operating environments (Windows, DOS, Mainframe). Must have proven skills in the following PC software products Lotus Notes, Excel, MS Word

Key Responsibilities:

• Contacts insurance companies to verify insurance benefits
• Initiates pre-authorization requests for new and ongoing services with insurance companies and performs follow up activities for an outcome
• Files Appeals for denied coverage to insurance companies as needed
• Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company
• Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care; provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable
• Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes; performs other related duties as assigned.

Qualifications:

• Minimum 1 year knowledge of VA, Workers Comp, PA Appeals is a must.
• Understanding of Medicare rules and regulations
• Understanding of managed care as it relates to benefits and authorizations
• Advanced MS Office experience; strong verbal and written communication skills
• Previous experience in a similar customer service role is preferred.
• Customer Service Experience: Previous experience in customer service is essential.
• Ability to learn quickly, retain information, and follow detailed instructions.
• Strong multitasking capabilities to manage various tasks simultaneously.
• High level of attention to detail to ensure accuracy in all aspects of the role.
• Good attendance record and reliability.
• Familiarity with working on complex computer applications and resource materials, and ability to navigate multiple operating environments (Windows, DOS, Mainframe).
• Patience, tact, empathy, and excellent organizational skills.