Documents Verification Specialist/Healthcare Customer Service
Randstad is currently seeking qualified customer service representatives. We have openings with an American worldwide health services organization in Bourbonnais, IL. Please send all qualified resumes to firstname.lastname@example.org
- Processes coverage determination requests received by mail, fax, electronic portal or telephone.
-Works in various queues to ensure proper handling of all processes related to coverage determination requests.
-Works with time sensitive material and must adhere to mandates turnaround times on all work.
-Responds to inquiries from customers for information and assistance related to coverage determinations.
-Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
-Seeks assistance with complex customer services issues.
-Makes outbound notification calls to members and/or their appointed representatives regarding status of requests.
Working hours: 8:00 AM - 4:30 PM
-Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions.
-General knowledge of formulary process, and branded versus generic drugs required. -Excellent verbal and written communication skills.
-Excellent customer service/people skills.
-Excellent telephone and PC/data entry skills.
-Ability to handle high volume of calls.
-Ability to multi-task, i.e. data entry with speed and accuracy while managing calls.
-Ability to handle and resolve escalated issues.
-Strong decision making skills to appropriately serve the customer.
-Ability to interact within a diverse workplace.
-Must be able to sit for the majority of shift and be comfortable working in a call center environment.
-All work is subject to review and follow up for errors and coaching by management staff/agency.
-Experience within role, at least 1 year
- Experience with creating and processing prior authorization is a plus
- Experience making outbound calls a to verify information is a plus
- Experience answering inbound calls is a plus
INBOUND/OUTBOUND CUSTOMER SERVICE
CALL CENTER ENVIRONMENT
EXCELLENT VERBAL AND WRITTEN COMMUNICATION SKILLS
ANSWER INBOUND CALLS
Minimum Degree Required: Completed High School (Diploma or GED)
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.