The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup. The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.
MAJOR DUTIES & RESPONSIBILITIES
- Handling Receipt of New Cases:
- Intake new cases and review/verify information and requests. Draft cases by entering information into the Dane Street system, AccessDS.
- Work with the client on any information missing pertinent to processing the claim.
- Sort, organize and create a medical document listing - if required by the client, and in line with specific special handling.
Oversight of Cases:
- Monitor, process and track cases to ensure we meet deadlines.
Assignment of Cases:
- Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.
- Ensure that the assigned physician has no conflict of interest with the case assignments
Client Interaction:
- Update clients frequently on cases in progress.
- May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.
- Ensure proper documentation for specified cases is provided to the client.
Requirements
COMMUNICATION: Indicate applicable type of communication
✓ External
✓ Internal
❏ Informational Persuasive
EDUCATION/CREDENTIALS:
An Associate’s Degree preferred.
JOB RELEVANT EXPERIENCE:
Business experience in a healthcare and/or insurance setting is preferred.
JOB RELATED SKILLS/COMPETENCIES:
Good communication skills with a clear understanding of company business lines. The ability to apply
critical thinking, manage time efficiently and meet specific deadlines. Computer literacy and typing skills
are essential.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and
computer work.
Benefits
We offer generous Paid Time Off, excellent benefits package and a competitive salary. Apple equipment and media stipend is provided for remote work space. Come up to speed quickly with our strong training program! If you want to work in an exciting, fast-paced environment where you can provide meaningful contributions, then we encourage you to apply.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful, astute forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers and Pharmacy Benefit Managers. We provide customized Independent Medical Exam and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.