Healthcare Customer Service

  • location: Phoenix, AZ
  • type: Contract
  • salary: $19 per hour
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job description

Healthcare Customer Service

job summary:
Intake Operations Coordinator

  • Processes phone and fax authorization requests for medical services from physicians and hospitals in an efficient accurate and customer-focused manner
  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status
  • Based on the information provided by the provider and gathered from computer systems determines the appropriate handling of each inpatient or outpatient request
  • Utilizes online tools to determine authorization requirements based on the type of service requested the location of the service and the provider specifics
  • Accurately enters authorization requests into company's system
  • Based on the authorization rules and urgency of the request either approves the authorization request or escalates to a nurse for review
  • Communicates authorization specific to providers either verbally on the phone calls or written through fax
MINIMUM QUALIFICATIONS

  • A High School or GED Required
  • 1+ year of experience in customer service experience Required
  • Other Call Center experience Preferred
  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Beginner Technology EMMA Beginner Preferred
  • Sidewinder Beginner Preferred
  • Peradigm (Diamond) Beginner
These will be for additional Behavioral Health prior authorizations we will be receiving. Behavioral Health background would be preferable.

 
location: Phoenix, Arizona
job type: Contract
work hours: 8 to 5
education: High School
experience: 2 Years
 
responsibilities:
Intake Operations Coordinator

  • Processes phone and fax authorization requests for medical services from physicians and hospitals in an efficient accurate and customer-focused manner
  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status
  • Based on the information provided by the provider and gathered from computer systems determines the appropriate handling of each inpatient or outpatient request
  • Utilizes online tools to determine authorization requirements based on the type of service requested the location of the service and the provider specifics
  • Accurately enters authorization requests into company's system
  • Based on the authorization rules and urgency of the request either approves the authorization request or escalates to a nurse for review
  • Communicates authorization specific to providers either verbally on the phone calls or written through fax
MINIMUM QUALIFICATIONS

  • A High School or GED Required
  • 1+ year of experience in customer service experience Required
  • Other Call Center experience Preferred
  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Beginner Technology EMMA Beginner Preferred
  • Sidewinder Beginner Preferred
  • Peradigm (Diamond) Beginner
These will be for additional Behavioral Health prior authorizations we will be receiving. Behavioral Health background would be preferable.

 
qualifications:
Intake Operations Coordinator

  • Processes phone and fax authorization requests for medical services from physicians and hospitals in an efficient accurate and customer-focused manner
  • Effectively handles authorization requests via phone or fax from providers, balancing excellent customer service with efficiency
  • Follows appropriate procedures for checking member eligibility, authorization history and provider network participation status
  • Based on the information provided by the provider and gathered from computer systems determines the appropriate handling of each inpatient or outpatient request
  • Utilizes online tools to determine authorization requirements based on the type of service requested the location of the service and the provider specifics
  • Accurately enters authorization requests into company's system
  • Based on the authorization rules and urgency of the request either approves the authorization request or escalates to a nurse for review
  • Communicates authorization specific to providers either verbally on the phone calls or written through fax
MINIMUM QUALIFICATIONS

  • A High School or GED Required
  • 1+ year of experience in customer service experience Required
  • Other Call Center experience Preferred
  • Knowledge of medical terminology and/or experience with CPT and ICD-9 coding Beginner Technology EMMA Beginner Preferred
  • Sidewinder Beginner Preferred
  • Peradigm (Diamond) Beginner
These will be for additional Behavioral Health prior authorizations we will be receiving. Behavioral Health background would be preferable.

 
skills: MS Office
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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