Customer Service Coordinator, Provider Unit

We are looking for an experienced Customer Service Representative to join our Provider Services Unit.

The Customer Service Representative responds to telephone inquiries from Health Plans, and Providers/Billing offices to provide information and clarification relating to RMG services such as claims, and eligibility in resolving inquiries.

Essential Duties and Responsibilities include the following:

• Ability to work independently in the resolution of telephonic issues.
• Process member address and phone number changes.
• Utilizes standardized processes, tools, researching and resolves routine or complex issues relating to services provided by a provider with in the medical group. This can include eligibility, provider availability and claim related issues.
• Anticipate our customer needs: Understand the wants and needs of customers, listen for cues and identify how to respond and what level of intervention they need.
• Provides basic claim information and claim status regarding external claims that have been submitted.
• Displays professionalism, warm and pleasant phone personality, emphasizing tact, empathy, good judgment and patience.
• Receives incoming calls through phone queues involving multiple issues from Health Plans, Providers, and Billing offices.
• Maintains or exceeds quality and productivity standards of a minimum of 65 calls per day with matching documentation.
• Additional duties as assigned.
• Ensures written and verbal communication with all levels of management, staff, vendors and property management or accurate and with good grammar.
• Handles designated assignments and prioritize work in order to maintain workflow.
• Maintain patient confidentiality so that HIPAA compliance is observed at all times.

Education and / or Experience:

• Minimum two (2) years of customer service and public relations experience in medical setting.
• Distinguishing the differences between CPT, HCPCS, Revenue, and ICD coding.
• Must be able to review and interpret health plan benefits and provider contracts.
• Ability to multi-task and meet deadlines in a high stress environment
• Strong organizational skills with emphasis on prioritizing and attention to details.
• Pleasant telephone manner as well as telephone etiquette.
• Self-starter, willing to take on multiple tasks.
• Must have excellent communication skills, both verbal and written.
• Ability to deal responsibly with matters of a confidential nature.
• Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point).
• Knowledge of computers, faxes, printers and all other office equipment.
• Able to interface with customers both internal and external of RMG.
• Ability to read, write and understand the English language.
• Ability to communicate effectively orally and written answering and resolving a minimum of 65 calls per day with matching documentation.
• High School Diploma or equivalent is required
• Typing 45 WPM with accuracy.

The pay range for this position at commencement of employment is expected to be between $18.50 and $20.50[hour]; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness:

• Behavioral Health Services
• Zero co-payments for employed physician office visits
• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Employee Assistance Program (EAP)
• Employer-Paid Life Insurance
• Vision insurance
• Flexible Spending Account (FSA)

Savings and Retirement:

• Income Protection Insurance
• 401k Retirement Savings Plan

Other Benefits:

• Business-casual working environment
• Paid holidays
• Employee Referral Bonus
• Employee Assistance Program
• License Renewal CEU Cost Reimbursement Program
• Company celebrations
• Vacation Time
• Tuition Reimbursement
• Mileage
• Sick days

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Job Types: Full-time, Contract

Pay: $18.50 - $20.50 per hour

Benefits:

• 401(k)
• Vision insurance
• Tuition reimbursement
• Life insurance
• Flexible spending account
• Dental insurance
• Employee assistance program
• Paid time off
• 401(k) matching
• Health insurance

Schedule:

• Monday to Friday
• 8 hour shift

Ability to commute/relocate:

• Northridge, CA: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Customer service: 1 year (Required)
• Call center: 1 year (Required)

Work Location: In person