Job Description
Position: Customer Service Representative
Facility: MDwise
Address: 2955 N Meridian St Suite 201, Indianapolis, IN 46208
Duration: 13 Weeks
Shift: 8 Hours/Days
Pay: $22/Hour W2
Position Summary:
This position will be responsible for daily member telephone calls which will include directing members to the proper services needed, educating members, problem solving, and creating linkages to the Medical Management Department for authorization of services. Also may be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.
Essential Functions and Responsibilities:
1. Meet the Department standard of calls answered, and call documentation entered.
2. Assist Members and Providers with questions and concerns.
Finding Provider(s)/Services for members
Arrange Transportation for members
Answer billing/claims status questions; resolve claim issues for members
Assist with pharmacy issues
Help Members access community support services
Verify member eligibility
Quote benefits
Assist with Referrals
Assist with member health assessments
Assist members with closing gaps in care
3. Ongoing member education.
4. Responsible for all benefits information given to Members and Providers.
5. Participate in Departmental Projects, as appropriate.
6. Coordinate quality improvement initiatives with Medical Management, Provider Relations, and Quality Depts., i.e., Preventative Health Screenings.
7. Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole.
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