Job Summary:
The Ops Support Agent will be working to ensure that reinstatements, modifications, and cancellations of insurance policies are timely and accurately updated in the necessary databases. You will have an important role in determining the patient's insurance status and extent of insurance benefits, ensuring an efficient billing process for medical providers.
**Responsibilities**:
- Reviews patient accounts for accuracy prior to placement to outside collection vendors
- Receive account change requests and review required changes.
- Update insurance plan changes on customer accounts.
- Review account information and update required information, balances, etc.
- Researches and responds to vendor inquiries
- Reviews correspondence in the CWF system and takes appropriate account and document action
- Reviews and authorizes affidavits related to patient billing, as applicable.
- Ensures vendor inventories reconcile to SSC systems by completing recons and updating I-Plans and or placements as needed by the end of each month.
- Assist with the Medicaid Eligibility vendor reconciliation, as requested. Manages the onboarding and termination process for vendors
- Provides support during vendor transitions: Medicaid Eligibility, Early Out, Primary and Secondary agencies.
- Responds to requests which include research payments, contractual, approving arrangements, audits, etc.
- Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
- Other duties as assigned
Skills and Experience:
- English - Spanish Language (Oral and writing 85% or higher), (B2+ or above).
- Must have a high school diploma.
- At least 1 year of experience in Customer Service or Backoffice positions.
- The resource will adjust its local schedule with the resources supporting this position during Daylight Savings time changes in the Eastern Time Zone.
- A genuine interest in working with and helping customers.
- Must possess excellent communication skills and involvement.
- Demonstrated experience in providing high levels of customer satisfaction and performance in a high transaction volume/high demand environment preferred.
- Good presentation and a polite, tactful, and friendly character.
- Healthcare experience is a plus.
- ** Communication**:
- communicates clearly and concisely, verbally and in writing. This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately.
- ** Customer orientation** - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
- ** Interpersonal skills** - able to work effectively with other employees, patients and external parties
- ** Policies & Procedures** - demonstrates knowledge and understanding of organizational policies, procedures and systems
- ** Basic skills** - demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately.