The Physician Support Unit (PSU) Rep I position will answer telephone calls in the physician line queue, meeting departmental standards for speed of answer and call volume, in a professional and respectful manner. This individual will be skilled at understanding how to research and resolve any issues pertaining to the pre-certification process. This includes knowing when and where to refer callers as needed; and full understanding of the appeals/reconsideration policy. This individual must be able to communicate professionally with the caller as needed.
- Maintaining a working knowledge of all process and procedure changes, CPT coding and updated training materials and use these changes and processes according
- Giving professional, courteous, and accurate information to all callers.
- Working with sites, patients, and physicians offices to investigate and resolve any pre-certification issues and know where to transfer calls when appropriate.
- Educating callers about the Health Plan requirements for pre-authorizations, reconsiderations, and appeals
- Analytical and well versed in Health Plan specific rules, regulatory and statutory
- Ability to learn and adapt quickly in a fast-paced environment
- Customer service focused with excellent communication skills
- Proficient in Isaac/Image One and case build required
Qualification & Experience:
- Experience with data entry and customer service.
- High School graduate or higher education.
- Previous customer service, medical experience, including medical terminology, medical billing and managed care preferred.
Vacancy Type: Full Time
Job Location: Wilkes, Barre PA, US
Application Deadline: N/A