Customer Service Healthcare Support Representative II (SCA)

Full Time
Remote
Posted
Job description
This is a remote position and qualified candidates must reside in one of the following locations: San Angelo, TX, Sunrise, FL, or Lathrop, CA.

As a Customer Service Healthcare Support Representative II (SCA), you will provide support in the Customer Service Department performing various administrative duties and clerical tasks as assigned in support of the company’s government healthcare contracts. This position primarily interacts with internal departments and resources, however, may have external client (or client representative) contact from time-to-time, and may provide support for one or more client contracts in support of the healthcare business. Primarily relies on pre-established guidelines and work instructions but can use judgment to resolve exceptions to data or workflow procedures. The position requires comprehensive skill working in MS Office, specifically Excel, and ability to quickly adapt to new client applications. May provide guidance and training to level I personnel.

Responsibilities:

  • Performs daily office tasks such as filing, recording, maintaining records, copying, posting transactions and other similar duties mainly using a computer

  • Collects, reviews and inputs data into computer systems following client and Performant policies, procedures and job duty work instructions

  • Answer phone calls and responds to internal inquiries

  • Reconciles account information or balances

  • Researches exceptions in data or established workflow procedures (troubleshoot)

  • Review and process (give guidance) on account media or correspondence

  • Assist in processing various account activities such as

  • o Account or inventory reconciliations
    o Identify and prepare adjustments for posting
    o Process refunds and other payment transactions,
    o Support account transition, assignment, or referral based upon established workflow procedures
    o Supports research and evaluation of account action for non-standard transactions, and escalates appropriately to ensure appropriate action is taken.
  • Review and process daily reports as may be applicable based upon program/workflow assignment. May help identify any potential issues in workflow or account activity based upon data variances or trends.

  • May support letter generation, as needed to support the business, which may include setting up or running mail merges (which may include high volume of accounts/transactions), reviewing and validating information, as well as stuffing envelopes, applying postage and ensuring drop-off to correct location for mail pick-up.

  • o
  • Communicate with external clients and/or subcontract contacts

  • o Verbal communication by phone
    o Written communication via established protocol
  • May Document workflow procedures

  • Convert/Import data files into readable format

  • Other duties as assigned to support business needs

  • Required Skills and Knowledge:

  • Knowledge of Microsoft Office products

  • o Create and modify spreadsheets in Excel, and regularly use Vlookup and pivot tables)
    o Establish and develop formulas in Excel
  • Must be able to work independently on assigned projects and complete within established deadline

  • Knowledge of subject matter or industry related to healthcare contracts, and/or specific client requirements and workflow procedures desired

  • Ability to multi-task and be highly flexible to meet changing priorities

  • Attention to detail without compromising speed or accuracy completing assignments

  • Ability to effectively communicate verbally and in writing

  • Ability to operate basic office equipment – fax, scanner, copier, printer, phone, postage meter, etc…

  • Additional Requirements:

    • Ability to obtain and maintain client requiredclearances as well as pass company regular background and/or drug screening.
    • Completion of Teleworker Agreement upon hire, andadherence to the Agreement (and related policies and procedures) including, butnot limited to: able to navigate computer and phone systems as a user to workremote independently using on-line resources, must have high-speed internetconnectivity, appropriate workspace able to be compliant with HIPAA, safety& ergonomics, confidentiality, and dedicated work focus withoutdistractions during work hours.

    Physical Requirements:

    **NOTE: Must be able to meet requirements for andperform work assignments in accordance with Company policies and expectationson a home remote basis (and must meet Performant remote-worker requirements)until at which time staff may be notified and required to work from aPerformant office location on an ad-hoc or periodic basis.

    Basic office equipment required to perform remote workis provided by the company.

    • Job is performed in a standard busy office environmentwith moderate noise level (or may be home-office setting subject to Companyapproval and Teleworker Agreement), sits at a desk during scheduled shift, usesoffice phone or headset provided by the Company for calls, making outboundcalls and answering inbound return calls using an office phone system; views acomputer monitor, types on a keyboard and uses a mouse.
    • Reads and comprehends information in electronic(computer) or paper form (written/printed).
    • Sit/stand 8 or more hours per day; has the option tostand as needed while on calls; reach as needed to use office equipment.
    • Consistently viewing a computer screen and typesfrequently, but not constantly, using a keyboard to update accounts.
    • Consistently communicates on the phone as requiredprimarily within the department and company and may include client contacts orother third-party depending on assignment with account holders, may dialmanually when need or use dialer system; headset is also provided.
    • Occasionally lift/carry/push/pull up to 10lbs.


    Education and Experience:

  • High school diploma or equivalent

  • 4+ years of Customer Service or similar professional office support experience.

  • Minimum 6 months experience working with healthcare claims

  • Knowledge of operations/work procedures related to one or more of Performant's business areas desired

  • Must be able to pass required background checks and clearances

  • Other Requirements:

    Performant is a Government contractor and subject tocompliance with client contractual and regulatory requirements, including butnot limited to, Drug Free Workplace, background requirements, and clearances(as applicable).

    • Must submit to and pass pre-hire background check, aswell as additional checks throughout employment.
    • Must be able to pass a criminal background check; mustnot have any felony convictions or specific misdemeanors, nor on state/federaldebarment or exclusion lists.
    • Must submit to and pass drug screen pre-employment (andthroughout employment).
    • Performant is a government contractor. Certain clientassignments for this position requires submission to and successful outcome ofadditional background and/or clearances throughout employment with the Company.

    Employment VISA Sponsorship is not available for this position.

    Job Profile is subject to change at any time.

    Performant Financial Corporation is an Equal OpportunityEmployer.

    Performant Financial Corporation is committed tocreating a diverse environment and is proud to be an equal opportunityemployer. All qualified applicants will receive consideration for employmentwithout regard to race, color, national origin, ancestry, age, religion,gender, gender identity, sexual orientation, pregnancy, age, physical or mentaldisability, genetic characteristics, medical condition, marital status,citizenship status, military service status, political belief status, or anyother consideration made unlawful by law.


    NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZEDAGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDERS.

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