- Strong communication skills (verbal/written)
- Strong coordinating ability
Ability to educate
Experience in explanation of insurance benefits
Time management and multitasking abilities
Experience with Brightree/Apacheta
General understanding of Respiratory care ecosystem
- Three (3) years Customer Service or Claims processing experience in a Third Party Administrators (TPA) or Health Maintenance Organization (HMO) environment
- Bilingual preferred
- Efficiently and courteously responds to telephone inquiries from subscribers regarding benefit verification, claims issues, and eligibility.
- Interprets plan coverage for subscribers and providers to determine correct level of benefit coverage.
- Provides claim filing instructions when needed to subscribers and providers.
- Provides telephone assistance to subscribers and providers, and verifies eligibility as required.
- Promptly returns phone calls resulting from inquiries that require additional research.
- Efficiently enters data simultaneously while listening attentively.
- Provides a high degree of confidentiality/discretion and independent judgment.
- Keeps workstations stocked and organized at all times.
- Performs daily clerical duties, including sending faxes, making copies, and assisting in other areas.
- Efficiently makes requested changes (temporary address changes, ID card requests).
- Ensures safe care to patients, staff and visitors, adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
- Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
- Other duties as assigned.
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CSR II - Houston, United States - Memorial Hermann Health System
Description
At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
Position is responsible for responding to inquiries from subscribers, providers and the client.Job Description
Location: Home Health North
Address: 16538 Air Center Boulevard, Houston, TX 77032 Shift: Monday to Friday 8AM to 4:30PM (remote but will require in office days) Desired skillset:
Minimum Qualifications
Education: Some college preferred
Licenses/Certifications: (None)
Experience / Knowledge / Skills:
Principal Accountabilities
