[Hiring] Customer Service Ops Support Specialist @Medlogix

Role Description

To support Customer Service Operations for all service products in all lines of business.

• Process EOB Request in Document Manager Inbox.
• Completes outgoing Billing provider calls to request bill/medical records.
• Claim message handling all carriers.
• Solely maintain/address CSBilling mailbox inquiries daily.
• Solely maintain/address CSIntake mailbox inquiries daily.
• Distribute daily WC Hospital notifications- sent daily by supervisor.
• Complete daily FROI report and send to WCMC by 2pm daily (Back only).
• Research and distribute Request for Precert (RFP Inbox) forwarding back to Precert, Carrier or provider.
• Specialize process Allstate NIS/ Precert request.
• Enter and distribute FROIs as assigned.
• Enters new Intake/Referrals into SYSTEM.
• Advises Customer Services/Intake Supervisor of activities and problematic issues.
• Utilizes various department Trackers (Productivity, Billing Tracker, Email) to track daily production.
• Login as “New Login” to CCS to be available as back up phone agent.
• FROI Mailbox distribution/Q&A (back up).
• Process updates to PE List, Employer Manager.
• Maintenance of FROI Right Fax address book.
• Can assist with training.
• Completes other tasks as assigned by Customer Service/Intake Supervisor.

Qualifications

• Knowledge of daily customer service operations and principles, including customer needs assessment, meeting quality standards for services and evaluations of customer satisfaction.
• Knowledge of corporate and departmental policies and procedures.
• Possess working knowledge of pre-cert, worker’s comp, group health, PPO lookup, and Bill Review process.
• Knowledge of insurance carrier plans.
• Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, designing forms and other office procedures and terminology.
• Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition and grammar.
• Knowledge of computer hardware and software.
• Knowledge of medical coding, i.e., CPT codes, ICD-9 codes, HCPCS codes.
• Knowledge of office equipment, i.e., telephone, computer, fax machine, copy machine, printer, e-copy scanner, calculator.

Requirements

• Bilingual Spanish highly preferred.
• Must have moderate analytical skills, to sift through verbal and written information in order to make a decision in relation to the problem presented.
• Must be able to remain focused on the issue at hand without digressing to non-related matters.
• Monitor and assess own performance and make improvements and or take corrective action.
• Excellent Communication Skills.
• Excellent Computer/Data Entry Skills.

Company Description

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’ needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; third party administrators (TPAs); and government entities we serve.