Shire Jobs

STARTING AT $17.20 - WAGE NEGOTIATED BASED ON EXPERIENCE AND QUALIFICATOINS. The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering members and providers questions with a quick and accurate response. They are also responsible for timely completion of all correspondence and reporting functions associated with the Customer Service Department. JOB REQUIREMENTS: 1.High School graduate or equivalent. 2.Strong ability to relate to all customers. 3.Excellent communication skills. 4.Possess some knowledge of the health care and insurance. 5.Computer and keyboard skills. 6.Proper usage of the English Language. 7.Consistently displays a positive attitude. DESIRED QUALIFICATIONS: 1.(2) year post high school education with focus on healthcare. 2.Previous call center experience. 3.Knowledge of medical terminology. 4.Knowledge of CPT and ICD-10 coding. 5.Familiar with medical and hospital claims. RESPONSIBILITIES: 1. Takes an average of 40-60 calls daily. 2. Keep pended work at tolerable range (when applicable). 3. Manage to work correspondence, faxes and e-mails in a timely manner. 4. Maintains monthly monitoring score of 90% accuracy or above on the 17 Points of Excellence. 5. Demonstrates a complete understanding of departmental policies and procedures. 6. Able to perform assigned tasks with minimal supervision. 7. Meets requirements on annual performance evaluation.