Urgently Required- Customer Service Representative/ Work From Office

Role & responsibilities

Experience

Responsibilities:

• Manage Inbound & Outbound calls and customer service enquiries, in this profile specifically agent will be answering an inbound calls which they will receive from the providers/pharmacies/members to seek assistance on benefits or on claim denials.
• US Medical/PBM denied Claims Handling process.
• Utilization Management handling including PA, Appeals, etc.
• RCM cycle that is used to manage the financial cycle of a patients encounter.
• Management and resolve customer complaints
• Identifying customers’ needs, clarify information, research every issue and providing solutions
• Following call centre “scripts” when handling different topics
• Work with the team to resolve issues with good aptitude
• Maintain and prepare activity reports.
• Maintains and improves quality results by adhering to standards and guidelines, recommending improved procedures.