Customer Service Professional

Customer Service Professional

Founded in 1994 and based in King of Prussia, Pa., MedRisk, Inc. provides specialty managed care services and automated claims workflow management tools to the workers’ compensation industry. With a demonstrated core competency in physical medicine, MedRisk uses advanced technology and evidence-based research to apply and integrate comprehensive physical medicine, prescription drug, and imaging management solutions to deliver savings that are significantly greater than traditional workers' compensation managed care programs. Its customers include insurance carriers, self-insured employers, third-party administrators, and general managed care workers’ compensation companies.  www.medrisknet.com

SUMMARY OF RESPONSIBILITIES:

The Customer Service Professional (CSP) is responsible for effectively and efficiently managing referral requests, appointment scheduling, verification and general inquiries for MedRisk’s end-user customers and providers, and prospective customers. This includes handling both inbound and outbound call assignments and accurately capturing the necessary client and provider data. The CSP will be intimately aware of all Customer Support Center policies, procedures and quality service level standards and will strive to consistently achieve those goals.

ESSENTIAL DUTIES INCLUDE THE FOLLOWING:

• Make outbound calls to Providers and Patients in order to schedule patient’s Physical Therapy, FCE, Chiropractic, etc.
• Make outbound telephonic/electronic contacts with adjusters and Physical Therapy Centers to verify new case information/missing information and request other related paperwork .
• Receive inbound phone and electronic referrals from insurance companies, doctor’s patients etc.
• Communicate with adjusters and nurse case managers regarding updates on patient status in a timely manner.
• Review case information/consult with Case Management to determine if new cases need to be opened or patient can be followed in existing case.
• Validate new case data by reviewing, correcting, deleting, or re-entering data; combining data when account information is incomplete; purging files to eliminate duplication of data.
• Request verification from insurance companies and other related paperwork from providers telephonically/electronically
• Understand MedRisk’s interdepartmental procedures, policies and comply with them.
• Identify potential or existing system and/or procedural challenges, and notify Supervisor and assist in resolution if needed.
• Consistently meet MedRisk Customer Support Service & Quality standards.
• Complete special projects or tasks as assigned by the supervisor.
• Apply knowledge of and adhere to the URAC Utilization Management Standards.
• Have skills to undertake proactive outbound calls to providers or other entities on behalf of MedRisk’s growth objectives as requested.
• Other duties as assigned.

Skills / Qualifications:

• Minimum 3 years of call center experience with both in-bound and out-bound calls (medium to high volume)
• Strong verbal communication skills
• Strong data entry skills
• Detail oriented and solid organizational skills
• Solid MS Word, Excel and Outlook experience
• Must have ability to multi-task and work independently
• Prior experience in health-related field and some knowledge of medical terminology/coding i.e. CPT/HCPCS and ICD9 experience a plus, but not required

·         Bilingual in English and Spanish is a plus, but not required

MedRisk offers competitive compensation commensurate with experience and benefits programs including medical, dental, life and 401k.  This is a full time position for local candidates only.  Contract related work will not be accepted.

MedRisk is an Equal Opportunity Employer committed to Affirmative Action and a drug free work environment. The company provides equal employment opportunities to all persons without regard to race, color, sex, religion, national origin, age, Vietnam era/disabled veteran status, disability, or other bases prohibited by applicable law.

For more information on MedRisk, please visit our website at http://www.medrisknet.com/