Phaxis LLC
Location: New York,NY, USA
Date: 2024-11-09T08:15:41Z
Job Description:
- Obtains information from doctors and/or providers and enters data into the medical management information system to enable clinical staff to correctly apply assessment tools.
- Creates case files for services that require authorization and maintains accurate data in all applicable systems to ensure prompt decision-making and accurate claims adjudication.
- Delivers strong customer service and problem solving while providing triage and management of calls with accuracy of data collection and ensuring established call performance targets are consistently achieved.
- Tracks and monitors customer complaints concerning service requests. Reports any unusual or complex issues/trends to management; recommends corrective actions.
- Provides triage and management of calls ensuring that established call performance targets are consistently achieved.
- Provides feedback to leadership regarding training needs
- Collaborates with management to determine the best approach to service customers, handle repeat vendor issues and other job-related matters to maximize and improve delivery, billing and payment of goods and services.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
- Participates in special projects and performs other duties as assigned.
- Has strong organizational skills
Work Experience:
- Minimum of two years of experience in a customer service role Required
- Excellent oral and written communication skills Required
- Advanced personal computer skills, including Word, Excel or Access Required
- Utilization Management experience Preferred
- Health care background Preferred