Customer Service Advocate Ii - Remote

Remote - Customer Service Advocate II

Start a rewarding career in healthcare at Imagenet!

Do you have a passion for helping others and making a positive impact on their lives? Are you looking for a challenging and rewarding career in the healthcare industry? If so, Imagenet is seeking exceptional Customer Service Advocate II to join our team.

About the Role:

Join our team as a Customer Service Advocate, where you will play a crucial role in taking provider calls in relation to claims, appeal and payment status. You will be a valued member of the team, providing exceptional Customer Service to our clients and providers by ensuring their satisfaction on calls. As a key contributor, you will be responsible for accurately and efficiently reading and relaying information read in client portal to providers. This position requires a solid understanding of the health care claims process flows and expertise in healthcare terminology, including ICD-9 and ICD-10 coding.

You will be responsible for:

Professionally taking calls from Healthcare Providers accurately identifying their specific needs such as:

Providing top-tier service to our clients

• Interact with providers to answer their questions and address their concerns. You will be their first point of contact and their trusted advisor to accurately relaying information.

Claims Management:

• Efficiently determine the status of claims (paid, denied, or in process) to provide timely and accurate information.
• Assess and communicate the status of appeals and retro authorization requests, ensuring providers are informed of denials, approvals, or pending decisions.

Documentation Assistance:

• Facilitate seamless operations by assisting providers in obtaining copies of Explanation of Benefits (EOB), expeditiously submitting them via email.
• Collaborate with examiners to rectify claim decision errors, ensuring a smooth process by utilizing the client system.

Document Tracking:

• Proactively track the receipt of essential documents in the client system, including medical records, W9 forms, itemized bills, and proof of timely filing.

Financial Inquiry Resolution:

• Address provider inquiries regarding check statuses, distinguishing between outstanding and cashed checks.

Exemplary Customer Service:

• Provide a consistently high standard of Customer Service, ensuring each interaction leaves a positive and lasting impression.

Performance Excellence:

• Meet and exceed established productivity, schedule adherence, and quality standards, contributing to a culture of excellence.
• Skillfully handle a high volume of inbound calls with efficiency and accuracy.

Relationship Building:

• Foster positive relationships with healthcare providers and their staff by delivering correct information and answering queries in a positive and professional manner.

What We’re Looking For:

To be successful in this role, you should have:

• Customer service experience. You have worked in a Customer Service role before, preferably in the healthcare industry for at least 1year. You know how to handle different types of customers and situations with professionalism and empathy.
• Computer proficiency. You are comfortable using computers and the internet. You can type fast and accurately, and you can learn new software quickly.
• Problem solving skills. You can analyze information, identify issues, and find solutions. You are resourceful and proactive in resolving customer inquiries.
• A positive attitude. You are friendly, courteous, and respectful to everyone you interact with. You are a team player who supports your colleagues and contributes to a positive work environment.
• Punctuality and reliability. You show up on time and ready to work. You follow the schedule and the policies of the company. You take your job seriously and perform it with excellence.
• A willingness to learn and grow. You are open-minded and coachable. You accept feedback and use it to improve your skills and performance. You act and trust in the coaching and training process.

The Ideal Candidate:

In addition to the above requirements, the ideal candidate is:

• Customer service oriented. You enjoy helping people and making them happy. You go above and beyond to exceed customer expectations and deliver exceptional service.
• A team player. You work well with others and share a common goal. You are supportive of your teammates and willing to help them when needed. You want to grow with the company and advance your career.
• Adaptable to change. You can handle different scenarios and adjust to changing client needs. You are flexible and resilient in the face of challenges and uncertainty.
• Skilled in communication. You have excellent verbal and written communication skills. You can express yourself clearly and effectively in English, both over the phone and online. You can use soft skills, empathy, and de-escalation techniques to handle difficult situations.
• With Customer Service experience: 1 year (Required)
• With Healthcare experience: at least 6 months (Required)

Education:

• High school diploma or equivalent (Required)

Job Type:

• Full-time

Salary: $15.00 - $19.00 per hour

COMPANY OVERVIEW

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

Imagenet LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.