12 days old

Customer Service Representative

Keystone Peer Review Organization, Inc.
Seven Hills, OH 44131
  • Job Code
    CUSTO02273-00001



KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.KEPRO is seeking resumes for a highly experienced professional.



Accountabilities



  • Assists callers on the Beneficiary Helpline

  • Answers the Beneficiary Helpline through the utilization of the hunt group and available light functions

  • Determines how to best assist caller either by a service offered by KEPRO or by referring them to an external agency and properly enter referral into CMS system

  • Responsible for typing/merging, proofing for clarity, printing, and mailing correspondence.

  • All letters sent out in timely manner with correct components included and reviewed for grammatical and spacing errors

  • Communicate verbally and in writing with external customers to furnish and request review information.

  • Get and validate notices and all components of medical records

  • Provide intake for all appeals received by KEPRO

  • Foster effective working relationships between KEPROs internal and external customers. Proficient in customer service guidelines and standards

  • Assist with and participate in Review Team in identifying areas for potential improvement, as noted on case reviews and process.

  • Utilize internal quality control tools to assess individual work and team processes.

  • Performs other duties as assigned by Review Support Supervisor.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.



Qualifications



  • High school diploma or equivalent.

  • Post high school business courses helpful.

  • Medical terminology desired.

Knowledge, Skills, Abilities



  • Excellent verbal communication skills, courteous and patient demeanor, must be customer oriented and have the ability to maintain composure under potentially stressful situations.

  • Good grammar, punctuation, spelling, hyphenation, and written communications skills.

  • Customer focused, results oriented and capable of building and maintaining relationships with internal and external customers. Must be flexible and able to work as a team member and support team decisions.

  • General knowledge of a PC based computer system desirable. Knowledge of various software packages with ability to learn additional software packages as needed.

  • Must be able to multi-task and to prioritize assignments.

  • Must have good organizational skills and be able to work independently.

Experience



  • Two to three years of clerical experience including word processing, various filing systems, and telephone customer service responsibilities.

  • Prior work in a healthcare setting or medical terminology recommended. Previous data entry or other clerical experience is a plus.

Mental and Physical Requirements



The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 20 pounds; and occasionally travel within the state.



KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements.Only those candidates identified for an interview will be contacted.No Phone Calls Please.Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.



EOE AA M/F/Vet/Disability



KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.



Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities



The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information.



See job description





Posted: 2019-10-31 Expires: 2019-11-29
Sponsored by:
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Customer Service Representative

Keystone Peer Review Organization, Inc.
Seven Hills, OH 44131

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