Customer Service Representative (Hybrid - Cary, NC)

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.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications:

Required Qualifications

• Requires a High School diploma or equivalent.
• Requires a minimum of two years of customer service experience.
• Medical terminology course(s) preferred.

Preferred Qualifications

• Knowledge of medical terminology.
• Knowledge of the health insurance industry.
• Effective verbal and listening skills.
• Bilingual Spanish-English a plus.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is listed below.

“Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Pay Range: USD $17.00 - USD $17.50 /Hr.