Call Center Representative – SCA (Remote)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary And Responsibilities

Acentra Health is looking for a Call Center Representative to join our growing team.

Job Summary

The Call Center Representative is a front-line service position aiding state benefit system members and providers regarding programs, policies, and procedures. Responsibilities include answering incoming calls related to eligibility, benefits, claims, and authorization of services from members or providers.

• This position is remote*

Responsibilities

• Available to work scheduled work hours based on operational needs.
• Accurately respond to inbound phone calls and processing provider and member inquiries.
• Under general supervision, resolve customers’ service or billing complaints by demonstrating sound judgement.
• Contact customers to respond to complex inquiries or notify them of claim investigation results.
• Refer unresolved customer grievances, appeals, and claim resolution to designated departments.
• Keep records of customer interactions and transactions.
• Actively listen and probe callers to determine the purpose of the calls.
• Research and communicate information regarding member eligibility and claims status.
• Assume responsibility for self-development and career progression.
• Educate providers on how to submit claims and when/where to submit a treatment plan.
• Perform necessary follow-up tasks to ensure member or provider needs are completely met.
• Support team members and participate in team activities.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications

Required Qualifications

• Requires a High School Diploma.
• Previous experience with computer applications, such as Microsoft Word and PowerPoint.
• Previous customer service-related experience required.

Preferred Qualifications

• Verbal and written communication skills, attention to detail, customer service skills.
• Ability to work independently and manage one’s time.
• Ability to accurately document and record customer/client information.