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Customer Service Representative
- Are you an experienced Customer Service Representative looking for a new challenge?
- Do you value care management and quality improvement?
- Are you motivated, energetic, and excited to become part of the Kepro team?
Who we need:
A Customer Service Representative to provide support by:
- Answering incoming telephone calls
- Resolving customer questions and complaints and requests
- Adhering to internal policies and procedures
- Utilizing working knowledge of the organizations services to meet productivity and quality standards.
Why us?
Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. Kepro is seeking resumes for a highly experienced professional.
People Focused. Mission Driven.
Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.
We do this through our people.
At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.
Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.
What you'll do:
- Establish a client record for all applicants.
- Handle and track queries from providers and members related to program and service eligibility and resolves issues or refers to appropriate parties for resolution within established timelines.
- Answer telephones, screen and direct calls appropriately.
- Process/generate correspondence related to program and service eligibility and prior authorization of services within specified timelines and completes required tracking.
- Research, investigate and assist providers to ensure appropriate resolution and tracking of inquiries related to prior authorization status and documents activities per established protocols.
- Document and log inquiry and complaint information within established timelines and protocols.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
What you'll need:
- Requires High School Diploma or equivalent; (Associates or Bachelors Degree in Human Services Field preferred)
Knowledge, Skills, Abilities
Knowledge:
- General knowledge of office environment and business processes
- General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
- Knowledge of CPT and HCPCS codes preferred
- PC proficiency to include Microsoft Office Suite
Skills:
- Excellent verbal and written communication skills
- Basic data entry skills
- Excellent customer service skills
- Ability to meet Departmental standards and established workload standards
- Ability to work well with management and team members to contribute to the achievement of departmental goals
- Ability to multi-task
- Strong organization skills
- Experience with Microsoft programs
Abilities:
- Must have ability to effectively communicate with team members and external customers
- Must have ability to research and resolve issues related to Medicaid program and service eligibility
Experience
- Requires minimum 1-2 years in an administrative support or customer service position
- Previous experience in the medical office or other medical setting preferred
Mental and Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.
Kepro offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at (link removed) for more information on the Kepro Family of Companies.
EOE AA M/F/Vet/Disability
Kepro is and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected vete
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