Concierge Customer Service Representative

9 hours ago

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MedWatch, LLC

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Healthcare Insurance • B2B

MedWatch, LLC is a healthcare services company that provides utilization management, case management, disease management, member advocacy and concierge care coordination to payers, TPAs, and self‑insured employers. For over 35 years it has delivered clinically driven care management, precertification and claims solutions, direct contracting and ancillary services backed by URAC accreditations and proprietary in‑house technology to improve clinical outcomes and reduce plan and member costs.

201 - 500 employees

Founded 1988

⚕️ Healthcare Insurance

🤝 B2B

📋 Description

• Accurately service and satisfy customers by responding to customer inquiries. • Respond to telephone and email inquiries received from members and provider within defined service standards. • Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers. • Assist members with benefits and healthcare questions. • Document all calls received in system-based call log. • The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice.

🎯 Requirements

• Minimum HS Diploma/GED, 2 years college or higher education preferred. • One year Customer Service / Call Center experience in a health care related role. • Medical Intake or Third-Party Administrator (TPA) experience preferred. • Bilingual English-Spanish a plus. • Patience and ability to handle difficult situations tactfully and diplomatically. • Strong customer relations, interpersonal skills. • Strong appreciation and ability to handle confidential & sensitive information. • Proficient with Microsoft applications, strong computer skills and computer navigation. • Excellent data entry and typing skills. • Knowledge of provider organizations and networks. • Knowledge and understanding of CMS Medicare reimbursement rates. • Ability to effectively negotiate rate structures. • Takes initiative to resolve situations and to accomplish projects actions and tasks. • Excellent verbal and written communication skills. • Independent judgment in decision making and problem solving. • Ability to multi-task and anticipate potential needs/problems. • Ability to build relationships with internal and external customers. • Medical Terminology. • Strong attention to detail. • Understanding of Self-Funded health benefits a plus. • Claim processing skills a plus. • Insurance verification or pre-certification a plus. • Provider office/facility billing department or financial area. • Strong analytical and research skills.

🏖️ Benefits

• paid time off • medical • dental • vision • short and long-term disability • life insurance • AD&D • 401k with match • critical illness coverage • legal plan • identity theft coverage • pet insurance • discount programs