Group Health Customer Service Representative

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Dane Street

Site WebLinkedInTous les Emplois

51 - 200 employés

⚕️ Assurance santé

📋 Conformité

🏛️ Gouvernement

Healthcare Insurance • Compliance • Government

Dane Street est un leader national dans les examens et évaluations médicales indépendants, fournissant des examens médicaux indépendants, des revues par les pairs et d'autres rapports médicaux objectifs, conformes et en temps opportun. Avec un vaste réseau de plus de 16 000 médecins, l'entreprise offre ses services dans plus de 25 000 emplacements et 100 spécialités, y compris les réclamations en matière de compensation des travailleurs, d'automobile, de responsabilité et d'invalidité. Dane Street soutient les assureurs, les administrateurs tiers, les organisations de soins intégrés et les entités fédérales/étatiques avec des analyses médicales expertes, les aidant à prendre des décisions précises. L'entreprise est reconnue pour sa qualité, ses délais d'exécution rapides et ses processus efficaces, recevant des distinctions telles que l'accréditation NCQA en gestion de l'utilisation et la certification Great Place to Work.

Description

• 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.

🎯 Exigences

• 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.

🏖️ Avantages

• 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 • 401k plan with a company match • Apple equipment and a media stipend for remote workspace