Description
American Specialty Health Incorporated is seeking a detail-oriented research representative for our Eligibility team. This position will research and resolve eligibility verification requests while providing the highest quality of customer service by maintaining a professional and courteous manner. The ideal candidate will have strong typing and 10-key skills while maintaining 98% accuracy. The research representative follows confidentiality guidelines to ensure security measures are enforced and proprietary information remains protected.
Remote Worker Considerations
Candidates who are selected for this position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).
Responsibilities
- Verifies member eligibility from the eligibility file, communications logs, and health plan websites or by calling the health plan directly when all other resources are exhausted.
- Inputs and saves verified member’s information into the communications log and/or member maintenance.
- Promptly processes and completes research to ensure turnaround times are met.
- Makes follow up calls to practitioners and members to provide research results.
- Builds or updates member and group records in ASH’s proprietary claims processing system including documentation in notes.
- Follows confidentiality guidelines to ensure security measures are enforced and proprietary information is protected
- Must maintain a minimum production level of 85 claims, 60 CSS/MNA, or 60 ASHLink requests per day pro-rata with no less than 98% accuracy.
- Ability to assist in multiple functions as needed.
- Ability to participate in peer mentorship as needed.
Qualifications
- High School Diploma required.
- Minimum one year experience with 10 key, typing, and computer skills. 7,000-10,000 key strokes per hour required.
- Excellent customer service skills, experienced in making outbound calls and meeting expectations for productivity and accuracy required.
- Experience with claims processing or eligibility verification preferred.
Core Competencies
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Ability to effectively organize, prioritize, multi-task and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters.
Mobility
Primarily sedentary, able to sit for long periods of time.
Physical Requirements
Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.
Environmental Conditions
Work-from-home (WFH) environment.