Denison, United States
almost 2 years ago
Under general supervision, takes inbound calls in a call center environment and performs outbound calls to existing providers to ensure accurate data is on file in multiple systems.
Inbound calls are from contracted providers and may be escalated.
Inbound/Outbound call team handles requests by mail, telephone, or in person regarding insurance claims/policies and provider contracts.
Responds to inquiries from provider and/or others for information and assistance.
Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
Mails or routes claim forms and supporting documentation to various units for final processing. Independently responds to inquiries or issues/complaints from routine to moderate complexity. Responsible for reporting and tracking provider calls.
Should be able to research multiple systems for resolutions and use critical thinking skills to resolve complex issues.
May seek assistance with complex issues.