Group Health Customer Service Representative

🕒 Junho 30

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $15 - $19 / hora

⏰ Tempo Integral

🟢 Júnior

💝 Suporte ao Cliente

👻 Score fantasma 31%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Dane Street

51 - 200 funcionários

🏥 Saúde

💼 Consultoria

⚖️ Jurídico

Healthcare • Consulting • Legal

A Dane Street é líder nacional em Exames e Revisões Médicas Independentes, fornecendo Exames Médicos Independentes (IMEs), Revisões por Pares e outros laudos médicos de forma objetiva, em conformidade e dentro dos prazos. Com uma ampla rede de mais de 16. 000 médicos, a empresa oferece serviços em 25. 000 localidades e 100 especialidades, incluindo sinistros de compensação trabalhista (Workers’ Compensation), automóvel, responsabilidade civil (Liability) e incapacidade (Disability). A Dane Street atende seguradoras, Third-Party Administrators (TPAs), organizações de Managed Care e órgãos federais/estaduais com análises médicas especializadas, ajudando-os a tomar decisões precisas. A empresa é reconhecida pela qualidade, prazos de entrega ágeis e processos eficientes, tendo conquistado credenciais como a Acreditação da NCQA em Utilization Management e a certificação Great Place to Work.

Descrição

• Handling Receipt of New Cases: • Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS. • Work with client on any information missing pertinent to processing claim. • Sort, organize and create medical document listing - if required by client, and in line with specific special handling. • Oversight of Cases: • Monitor, process and track cases to ensure we meet deadlines. • Assignment of Cases: • Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements. • Ensure that the assigned physician has no conflict of interest with the case assignments. • Client Interaction: • Update clients frequently on cases in progress. • May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer. • Ensure proper documentation for specified cases is provided to the client.

🎯 Requisitos

• A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required. • Experience working in a healthcare (medical office, insurance claims, etc.) environment preferred. • Excellent computer skills (Apple Operating System, Google Chrome search engine, Gmail are preferred). • Stellar written and verbal communication skills, including a high comfort level in speaking with the referring client, claimants, and/or physician. • Ability to maintain focus and attention to detail in a fast-paced environment. • Ability to manage multiple tasks and quickly changing priorities. • Excellent organizational skills.

🏖️ Benefícios

• medical, dental, and vision coverage for you and your family. • voluntary life insurance options for you, your spouse, and your children. • other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. • basic life insurance, short-term disability, and long-term disability coverage at no cost. • generous paid time off policy ensures you have time to relax and recharge. • 401k plan with a company match helps you plan for your future. • Apple equipment and a media stipend are provided for remote workspace.

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