Call Center Specialist
- Employment Status
- Full Time
Do you have call center experience and exceptional customer service skills? Then Pro Staff would like to speak with you about a Provider Contact Center Specialist opportunity at our client company in Alexandria that administers health care plans for 13 rural MN counties.
In this temp-to-hire role, you’ll be the first point of contact for providers who communicate the company about accuracy and timeliness of claims payments, prior authorizations, Appeal procedures, product information, benefit/eligibility verification, and general plan information. You’ll help identify member/provider issues and responds accordingly.
Main duties include:
- Answer inbound calls from providers and work to resolve their questions/concerns regarding eligibility, claims, authorizations, and program issues
- Place outbound calls to providers to provide follow-up on provider-generated issues and education when a claim processing issue is identified
- Ensure timely and accurate response to calls
- Remain up-to-date on Minnesota Department of Human Services/Centers for Medicare & Medicaid Services (DHS/CMS) requirements and provider manual changes and provider updates
- Confirm accuracy of information given to members/providers
- Initiate contact with the Provider Contact Center Coordinator & Provider Contact Center Manager when an issue can’t be resolved immediately and route the caller to the appropriate staff person for resolution
- Alert management of repeat phone calls due to issues that have not been resolved within standards
- Assist in providing excellent customer service by performing ad hoc duties as defined by the Provider Contact Center & Claims Examination Manager
- Assist with provider web portal registration as assigned
- Assist with reprocessing and claims adjustments as assigned
- Associates degree and/or 2+years of medical claims experience
- Proficiency with MS Office applications
- Demonstrated organizational skills and ability to handle multiple tasks
- Attention to detail
- Exceptional phone and customer service skills
Pro Staff, an Atterro Human Capital Group company, offers short-term to long-term projects, temporary to contract-to-hire, or direct placements. With proven expertise in Administrative, Clerical, Light Industrial and Manufacturing backgrounds, Pro Staff matches the right people with the right career opportunities.