Location: Nashville, TN
Our client is currently seeking a Customer Service professional with claims help desk or call center experience to take on the role of a Customer Service Specialist at their Nashville, TN office. The Customer Service Specialist will be responsible for responding to customer inquiries and performing regular phone calls and related documentation quality assessments. This is a long-term, contract position. Monday – Friday schedule, 7:30am -4:30pm or 8:00am – 5:00pm shift.
- Answer and respond to customer inquiries related to Provider claims submission and payment status which require follow-up or escalation.
- Upload and observe EDI transactions.
- Monitor all EDI file processing and troubleshoot process to resolve all transaction file issues.
- Participate in training to stay up to date with industry changes, communicates with State Fiscal Agent staff for customer service response updates.
- Acquire working knowledge of company operating platforms.
- Manage and maintain records/documentation for audit and internal control needs.
- Respond to support tickets in a timely manner.
- Understand and meet program goals, maintain dashboard to communicate program performance.
- Handle customer service issues of varying complexity related to service authorizations, program enrollment, and guidelines, tax forms, workers’ compensation, invoicing, etc.
- Work directly with vendor and insurance companies to research and resolve any issues involving electronic transitions.
- A minimum of a Bachelor’s Degree and 2 years of customer service experience in an automated system environment (help desk or call center) which included application support, performance management, and reporting are required.
- Prior experience in health and human services, credentialing, service provision and claim billing is required.
- Excellent interpersonal, written, and verbal communication skills with strong customer service orientation.
- Strong time management and organizational skills are required.
- Must be able to read, analyze and interpret business periodicals, journals, technical procedures, and government regulations.
- Proficiency using Microsoft Windows, Excel and Word.
If you are qualified for this position, please apply using our secure online form.