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- Tempe, AZ
- Christine Mitchell
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PrideStaff • Tempe, AZ
Posted 18 days ago
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Customer Service Professionals (CSP’s) are responsible for supporting client retention and PT referral objectives by consistently providing an easy, efficient and productive customer experience for callers, by the timely scheduling of PT & related communication back to the adjuster or nurse case manager.
Essential Responsibilities & Duties:
1. Receive inbound phone and electronic referrals from insurance companies, NCMs, provider centers, doctors, patients etc.
2. Open new cases accurately according to policy and procedures.
3. Make outbound telephonic/electronic contacts with adjusters and Physical Therapy Centers to verify new case information/missing information and request other related paperwork.
4. Communicate with adjusters and nurse case managers regarding updates on patient status in a timely manner.
5. Maintain TAA goal (Total Agent Availability) monthly.
6. Review case information/consult with Case Management to determine if new cases need to be opened or patient can be followed in existing case.
7. 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.
8. Request verification from insurance companies and other related paperwork from providers telephonically/electronically.
9. Make outbound calls to Providers and Patients in order to schedule patient’s Physical Therapy, FCE, Chiropractic, etc.
10. Understand interdepartmental procedures, policies and comply with them.
11. Identify potential or existing system and/or procedural challenges, and notify Supervisor and assist in resolution if needed.
12. Consistently meet Customer Support Service & Quality standards (call monitoring and EOC monitoring).
13. Complete special projects or tasks as assigned by the supervisor.
14. Apply knowledge of and adhere to the URAC Utilization Management Standards.
15. Other duties as assigned.
Minimum Formal Education:
Bachelor’s degree strongly preferred
Minimum Work Experience:
Minimum of 3 years of call center experience with both in-bound and out-bound calls (medium to high volume).
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
Excellent verbal and written customer service skills demonstrating a can-do attitude.
Highly developed problem-solving 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
Bilingual in English and Spanish is a plus, but not required
- Office environment
- Sedentary work. Exerting up to 10 pounds of force occasionally.
- While mostly sedentary, the job includes walking, standing, sitting, possible twisting, kneeling
- Visual acuity (color, depth perception and field of vision)
- Substantial movements (motions) of the wrists, hands, and/or fingers
- This position requires consistent communication not only verbally but electronically. Candidate must be able to use verbal and written communication skills.