Company Overview:
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Job Summary and Responsibilities: Acentra Health is looking for a Customer Service Representative to join our growing team.

Job Summary:

• The purpose of this position is to answer incoming telephone calls, and resolve customer questions, complaints, and requests while adhering to internal policies and procedures.

Responsibilities:

• Develop and maintain working knowledge of internal policies, procedures, and services.
• Utilize automated systems to log and retrieve information; perform accurate and timely data entry.
• Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times.
• Respond to telephone inquiries in a prompt, accurate, and courteous manner.
• Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients.
• Perform verification of healthcare services to facilitate payment for received services.
• Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data.
• Serve as liaison between the internal and external partners.
• Investigate and resolve or report provider problems.
• Meet or exceed standards for call volume and service level per department guidelines.
• Initiate cases by collecting and entering demographic, provider, and procedure information into the system.
• Complete daily, monthly, and quarterly reports necessary for clinical team operations.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications:

REQUIRED QUALIFICATIONS

• Requires a High School diploma or equivalent.
• Requires a minimum of two years of customer service experience.
• Effective verbal and listening skills.

PREFERRED QUALIFICATIONS

• Requires a High School diploma or equivalent.
• Requires a minimum of two years of customer service experience.
• Effective verbal and listening skills.

• Develop and maintain working knowledge of internal policies, procedures, and services.
• Utilize automated systems to log and retrieve information; perform accurate and timely data entry.
• Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times.
• Respond to telephone inquiries in a prompt, accurate, and courteous manner.
• Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients.
• Perform verification of healthcare services to facilitate payment for received services.
• Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data.
• Serve as liaison between the internal and external partners.
• Investigate and resolve or report provider problems.
• Meet or exceed standards for call volume and service level per department guidelines.
• Initiate cases by collecting and entering demographic, provider, and procedure information into the system.
• Complete daily, monthly, and quarterly reports necessary for clinical team operations.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules