CSR I - Care Mgt (Intake Coordinator)

What does PHCS offer you?
Opportunity. Recognition. SatisfactionYou've worked hard to get where you are, but you're ready for bigger opportunities that expand your skills and enrich your career. At Private Healthcare Systems, you'll have them. As the national leader in health care cost management with a growing national customer base, we have been building a strong and stable organization for over 21 years. We work together to exceed customer expectations and take everything we do to the highest standards of which we are capable. That means always learning, always seeking challenge, always respecting one another, and always putting forth our best effort. We are proud of what we are building at PHCS, and proud of what we offer. If you join our team, you will be too.Effectively accept and respond to customer calls and inquiries regarding benefit office and network provider information. Initiate and complete notification processes and initiates system files (or cases) for clinical reviewers and notification processes, as well as POS assignments, changes and referrals with support from PHCS Care Coordinators while adhering to PHCS policies and procedures, AAHCC/URAC, state and federal regulations.Essential Functions:
Consistently meet or exceed standards for call volume and service level per department guidelines. Efficiently search system to determine customer's group name and number. Obtain and correctly enter customer information into the system. Determine type of provider requested, proper market definitions and refer customer to appropriate network provider. Effectively communicate to customer accurate provider and benefit office information. Effectively utilize the benefit summary screen to ensure proper information is delivered. Initiate files by collecting and entering demographic, provider and procedure information into the system. Utilize available on and off line tools to complete the notification process. Check caller's product affiliation/referral only status to ensure proper completion of process and eliminate errors in the system.No relocation assistance available.PHCS is an equal opportunity employer - M/F/D/V
REQUIREMENTS
* High School Diploma or GED 2+ years customer service/telephone experience in a similar call center environment and/or industry Ability to utilize PC keyboard efficiently and accurately. Proficient data entry skills. Type 30+ words per minute Demonstrated effective verbal communication skills and ability to convey information clearly and effectively
Demonstrated familiarity with telephone techniques and skills Working user level knowledge of PCs and ability to navigate through applications Working knowledge of medical and claims terminology