Customer Service Representative

Job Description

Job Description

Salary : WHO IS GUIDEHEALTH?

WHO IS GUIDEHEALTH?

At Guidehealth, our mission is to enhance healthcare affordability for patients and restore the fulfillment of practicing medicine for providers.

As a physician-led company, we recognize that streamlining administrative tasks and harnessing the power of predictive analytics and AI enable our partner physician practices prioritizing delivering high-quality healthcare focused on outcomes and value.

Driven by empathy, we empower physicians to anticipate the needs of patients requiring more attention, strengthen connections between patients and physicians with virtually-embedded Healthguides, and leverage AI and analytics to proactively avoid preventable events.

This approach results in increased levels of patient and practice engagement, ultimately leading to more significant positive impacts on patients.

Join us as we put healthcare on a better path!!

Our Customer Service Representatives are responsible for answering the phones in a timely manner, being a skilled problem solver, have the ability to work well with others along with meeting set quality standards.

Be courteous and professional while providing information to callers. Plus additional projects and assistance with mailing projects as needed.

WHAT YOU’LL BE DOING

• Assuring the accurate and timely handling of client and member calls with total follow through
• Providing excellent customer service
• Answering client and provider questions including, but not limited to claims payment, status and coverage information
• Interpreting client health plan protocol
• Backup to the claims processing area by assisting with reports and workflow queues as assigned
• Check tracer documentation
• Maintaining accurate and complete call documentation
• Maintaining high level of professionalism
• Returning incoming calls
• Other duties as assigned

WHAT YOU'LL NEED TO HAVE

• 1 to 3 years customer service experience in healthcare required.
• Knowledge of healthcare claims processing required.
• Experience in a high-volume call center
• Health Care / Health insurance background required.
• Experience with BCBS HMOI or other insurance plans a plus
• Use of multiple systems including Microsoft Office
• Excellent verbal and written communication skills
• Must be available for an 8 hour shift between 8am to 6pm Central time.

WHAT WE WOULD LOVE FOR YOU TO HAVE

HMO Managed care Medicare Advantage experience.

COMPENSATION

Guidehealth’s compensation structure includes more than just base salary. We believe in providing world-class benefits including comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match.

Our paid time off program includes paid holidays and flexible time that focuses on meeting the demands of the position and our clients, while providing the balance that our employees need.

The base pay range for this role is between $18.45 to $20.50 per hour, paid bi-weekly per our standard payroll practices.

Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to : skill set, years of relevant experience, education, location, and licensure / certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.

This position is responsible for following all Security policies and procedures in order to protect all PHI under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.

For any security-specific roles, the responsibilities would be further defined by the hiring manager.

remote work