Houston, NA, United States
4 hours ago
Client Service Representative - Operations

Company Description

HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization and care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment. HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth. Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp is headquartered in Houston, Texas. HealthHelp provides equal opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws. If you need assistance in completing this application due to a disability, please contact a member of the Talent Acquisition Group to request an accommodation or an alternative application process by emailing [email protected]

Job Description

•    Conducts administrative intake and scripted clinical intake of calls for clinical review
•    Provides quality customer service through interaction with providers, administrative staff and others
•    Builds and maintains customer satisfaction with products and services; provides excellent service to internal and external customers
•    Collects and enters confidential information ensuring the highest level of confidentiality in all areas
•    Maintains high-quality documentation standards when collecting and performing data entry functions
•    Provides ongoing telephonic support to providers and office staff related to HealthHelp’s Clinical Review process
•    Provides administrative support to the Clinical Review Department if needed
•    Participates and understands scope of responsibility pertaining to ongoing Quality Initiative Projects
•    Maintains acceptable levels of performance for all Key Performance Indicators, such as Average Talk Time (ATT), Quality, and adherence to schedule
•    Participates in the HealthHelp Quality Management Program as required
•    Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
•    Adheres to both URAC & NCQA standards in keeping with HealthHelp’s compliance initiatives 
•    Carries out other projects and responsibilities as assigned
 

Qualifications

•    High School Diploma/GED, required
•    One (1) year of customer service experience, required
•    Ability to hard line internet into computer equipment provided, required
•    Internet upload speed of 5 mbps and download of 25 mbps, required (verified at onboarding)
•    Ability to adhere to strict schedule with ability to adapt to schedule changes, as schedules are subject to change every three months, required
•    Prior experience in a fast-paced in-bound call center environment, preferred
•    HIPAA compliant room, required (verified at onboarding)
•    Prior experience in the healthcare industry (i.e., prior authorizations, patient care, CPT codes, etc.), preferred
•    Ability to read clinical terminology with high levels of proficiency
•    Ability to work efficiently in a fast-paced, high call volume, performance driven Contact Center
•    MS Outlook and Windows proficiency
•    Ability to work on dual monitors and navigate multiple software applications simultaneously
•    Strong time management skills
•    Highly skilled at delivering client and customer satisfaction
•    Must possess strong verbal and written communication skills

Additional Information

HealthHelp provides equal opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws. If you need assistance in completing this application due to a disability, please contact a member of the Talent Acquisition Group to request an accommodation or an alternative application process by emailing [email protected]

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