Experienced Physician Advisory Services Customer Service Representative – Healthcare Claims Management and Customer Support

At careerzynith, we're dedicated to revolutionizing the healthcare claims management industry with our cutting-edge technology and exceptional customer service. As a key member of our team, you'll play a vital role in ensuring seamless communication between our clients and medical professionals, facilitating the efficient processing of insurance claims. If you're passionate about delivering top-notch customer support and have a knack for navigating complex healthcare systems, we want to hear from you!

• *About careerzynith**

careerzynith is a fast-paced, Inc. 500 Company with a high-performance culture, processing over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. Our customized Independent Medical Exams and Peer Review programs help our clients reach the appropriate medical determination as part of the claims management process.

• *Job Summary**

We're seeking an experienced Physician Advisory Services Customer Service Representative to join our team. As a key member of our customer support team, you'll be responsible for:

• Handling the receipt of new cases, ensuring proper system drafting and setup
• Taking direction and facilitating the case assignment/scheduling process
• Providing exceptional customer service to our clients, ensuring timely and accurate communication
• Collaborating with medical professionals to ensure seamless case processing
• Maintaining accurate records and documentation

• *Available Shifts**

We offer flexible scheduling to accommodate your needs, with available shifts:

• 9:30 am - 6:00 pm EST
• 10:00 am - 6:30 pm EST

• *Major Duties & Responsibilities**

• **Handling Receipt of New Cases**
• Intake new cases and review/verify information and requests
• Draft cases by entering information into the careerzynith system, AccessDS
• Work with clients on any information missing pertinent to processing claims
• Sort, organize, and create medical document listings, if required by clients
• **Assignment of Cases**
• Assign/schedule new cases to physicians for review with the appropriate physician
• Ensure that the assigned physician has no conflict of interest with the case assignment
• **Oversight of Cases**
• Monitor, process, and track cases to ensure timely completion
• **Client Interaction**
• Update clients frequently on cases in progress
• Communicate with clients when there are questions on referral information
• Ensure proper documentation for specified cases is provided to clients

• *Requirements**

• **Education/Credentials**
• An Associate's Degree is preferred
• **Job Relevance Experience**
• Business experience in a healthcare and/or insurance setting is preferred
• **Job-Related Skills/Competencies**
• Exceptional communication skills with a clear understanding of company business lines
• Ability to apply critical thinking, manage time efficiently, and meet specific deadlines
• Computer literacy and typing skills are essential

• *Working Conditions/Physical Demands**

• Long periods of sitting and computer work
• Any lifting, bending, traveling, etc. required to do the job duties listed above

• *Work from Home Technical Requirements**

• Supply and support their own internet services
• Maintaining an uninterrupted internet connection is a requirement of all work-from-home positions

• *Benefits**

• Comprehensive benefits package designed to support your well-being and peace of mind
• Medical, dental, and vision coverage for you and your family
• Voluntary life insurance options for you, your spouse, and your children
• Other voluntary benefits, including hospital indemnity, critical illness, accident indemnity, and pet insurance plans
• Basic life insurance, short-term disability, and long-term disability coverage at no cost
• Generous paid time off policy to relax and recharge
• 401k plan with a company match to help you plan for your future
• Apple equipment and a media stipend for remote workspace

• *How to Apply**

If you're passionate about delivering exceptional customer support and have a knack for navigating complex healthcare systems, we want to hear from you! Apply now to join our team at careerzynith and take the first step towards a rewarding career in healthcare claims management.

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