Customer Service Specialist
: Job Details :


Customer Service Specialist

Companalyst

Job Location : Modesto,CA, USA

Posted on : 2024-09-28T06:45:14Z

Job Description :

* Customer Service Specialist in Brown & Toland Physicians

**Customer Service Specialist**

POSTED ON 3/7/2022 AVAILABLE BEFORE 5/6/2022 Brown & Toland Physicians Modesto, CA Remote Full Time Job Posting for **Customer Service Specialist** at **Brown & Toland Physicians** Under close supervision, the Customer Service Specialist (CSS) is responsible for the effective and thorough handling of telephonic inquiries from all B&T customers. Accurately responds to inquiries on B&T policy regarding: claim status and adjustment, authorization and referral, eligibility, network composition, access and quality of care. Works with other B&T departments in the resolution of all customers inquires in a timely manner. Tracking of all inquiries and appropriate follow-up are required.

**Qualifications**

* Required Education: High school Diploma or G.E.D.

* **Minimum Experience: 3 years customer service experience in a medical / healthcare call center environment**

* Claims / Referral Services experience

* Epic/EMR Experience

* Customer Service Phone Queue Experience

**Job Duties & Responsibilities**

* Responsible to answer inbound and outbound calls for Claims, Customer Service and Referral Services department ACD queues; ensures that all telephonic inquiries are resolved satisfactorily and maintains professional and considerate relationships with all B&T customers both internal and external striving for excellent customer service; conveys confidence and expertise through the utilization of appropriate reference materials when answering all inquiries; listens attentively to customer issue(s) and deciphers customers needs to resolve in a competent, professional and thoughtful manner.

* Coordinates with internal and external sources to obtain necessary information to resolve customer issues creatively; escalates issues as appropriate to Lead, Supervisor or Manager.

* Provide education and assist in trouble shooting to offices related to enrollment and appropriate use of BTCare, eFax and submission of clinical notes; solves problems creatively while consistently maintaining professionalism in all customer (internal and external) interactions.

* Functions as part of a team contributing to the goals of the department with a positive and professional manner; works in a rotation with peers to provide coverage for the Front Desk based on schedule determined by leadership.

* Meets or exceeds all established production and quality standards; adheres to assigned schedule and manages time off effectively and is compliant with the absence and tardiness policies as outlined in the employee handbook.

* Must be able to research complicated issues and follow up with providers or members within the established turnaround time measures.

* Assist the team with the management of the contact us portals on Brown & Toland website and respond to member inquiries within established turnaround time; triage of all incoming faxes to the Customer Service fax line based on schedule determined by leadership.

* Support of company initiatives related to AHA health fairs and Open enrollment meetings. Attend a minimum of 1 event per year.

**Knowledge, Skills & Abilities**

* Proficient computer skills including Microsoft Office (Word, Outlook, Excel, PowerPoint).

* Use independent judgment and initiative within established policies and procedures.

* Ability to Interact and maintain excellent relationships with internal and external contacts to support compliance and high levels of service.

* Be an Ambassador for Brown & Toland and create a positive customer experience by utilizing your skills in Superior oral and written communication skills. Use a professional approach at all times to problem resolution, strong organizational skills, ability to prioritize projects, and maintain an excellent attendance record.

* Understanding and application of ICD-10, RVS, CPT codes, basic medical terminology and systems experience is required.

* Knowledge of medical terminology, enrollment and membership activities and claims processing procedures/systems is required.

* Ability to work as an effective team member recognizing the need for a positive manner at all times.

* Solves problems creatively while consistently maintaining professionalism in all customer (internal and external) interactions.

* Must be able to communicate with internal and external customers at all levels of management.

* Must be able to handle escalated communication professionally and efficiently

Job Type: Full-time

Pay: $19.00 - $21.00 per hour

Benefits:

* 401(k)

* Dental insurance

* Health insurance

* Paid time off

* Work from home

Schedule:

* 8 hour shift

Education:

* High school or equivalent (Required)

Experience:

* Healthcare Customer Service: 1 year (Required)

* EMR/Epic: 1 year (Required)

Work Location: One location

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