Customer Service Rep - Provider Services Advocate -

Location: Mechanicsburg, PA
Date Posted: 09-01-2017
TDY Medical Staffing, Inc. is currently looking for a Provider Service Advocate/Customer Service. This is a Day Shift position - 37.5 hours per week Mon - Fri 8a-4p for first 2 months while training, 10a-6p for remainder.  Contract Temp position with potential to be hired full time permanent.   Once you apply, please check your email as we will communicate with you via this means. 
The Provider Services Advocate responds to Medicare Part A and/or B telephone and/or written inquiries from the Medicare provider community which includes billing offices, medical societies, provider consultants, Managed Care Organizations, attorneys, etc. regarding Medicare coverage guidelines and policies covering a wide range of topics to include provider enrollment, Medicare appeals, debt recovery, claim payment information, telephone reopening requests, and general coverage for multiple provider specialties.   

TDY will consider a candidate’s compliance with the application instructions to be indicative of the type of conduct that it may expect from the candidate during employment. Therefore, failure to comply with these instructions may be grounds for exclusion from employment consideration.

Please read everything below before applying and only apply if you are fully qualified.  Must have documented experience working with Medicare A/B.    Must have MS Office/Outlook documented on your resume as well as computer experience.  Please submit a resume with 3 professional references - please list your skills online in the area provided after you hit the APPLY button.  If you do not submit a resume with professional references, you will not be considered for employment.
 
TDY does extensive background checks, reference checks and pre-hire/random drug screening as a condition of employment.  Must be able to lift up to 10lbs .  You must have computer experience beyond using the internet and email!  TDY has high expectations of staff to be able and available to work 40 hours per week as this is a full time position.
 
MANDATORY REQUIREMENTS:
Contract Workers must have a High School diploma or GED Certification at a minimum, PC experience is required and must be reflected on your resume.  You must have good clerical and organizational skills, be quality-oriented, have the ability to work in a team-oriented environment and to handle multiple tasks daily by priority, and the ability to adapt to continual processing changes. We are seeking "team oriented" persons. 
  • 2 or more years’ experience in call center, customer focus, or claims experience.
  • Proficient with Microsoft Office to include Outlook.
  • Demonstrated Internet research skills
  • Strong problem solving and decision making skills
  • Lift up to 10 lbs
Preference given if you have the following experience: 
  • Some college education
  • Experience in the insurance industry or medical coding or related work experience
  • Bilingual skills
 
  • Research and Problem Identification: 25%
    • Access multiple systems to research customer problems and record inquiry types.
    • Research CMS and company websites to provide knowledge and education to customer on additional resources which can be used in the future.
    • Access the IVR and Internet Portal systems as needed to help educate customers on self-service options that are available to them.
 
  • Problem solving and Analysis: 25%
    • Review claims processing systems to identify specific claim edits and audits applied on claims.Analyze claim edits and audits to determine reasons for claim denials.
    • Review debt recovery systems to troubleshoot reasons for pending accounts receivables and the generation of overpayment demand letters. Review and analyze data to determine reasons for overpayments.
    • Review local medical coverage and national medical coverage policies in order to troubleshoot reasons for claim denials and reductions.
    • Review other system to address and determine resolution to other customer issues to include pending appeals, aged claims, and Medicare Secondary Payer.
 
  • Customer Service: 50%
    • Engage in dialogue with all customers using a customer-friendly tone even when challenged with overly aggressive customers.
    • Respond to each customer’s need and request and ensure each customer’s encounter is positive and productive.
    • Use good verbal and written communication during each customer encounter and never use jargon and slang.
    • Embrace diverse backgrounds and understand the needs of those customers who may not have as extensive knowledge of Medicare rules and regulations.Tailor responses to ensure customers receive the maximum benefit when calling Medicare.

TDY Medical Staffing, Inc. is an Equal Opportunity Employer and takes pride in maintaining a diverse environment.  All qualified applicants will receive consideration for employment without regard to their race, color, religion, gender, gender identity, national origin, age, sexual orientation, marital or protected veteran status, disability, or any other legally protected status.  If you’d like more information about your EEO rights as an applicant under the law, please click here.

Once you hit the “Apply Now” button, you will be directed to enter into your information into our website general application – There will be several questions asked to ensure our Affirmative Action/EEOC compliance. Your participation is voluntary and will have no impact on the interview process. 

TDY is a federal contractor and as such is required to provide self-identification questions regarding  race/gender/disability/veteran status to all qualified applicants.  We offer all applicants the VOLUNTARY opportunity to respond to the questions. 
You are under no obligation to respond to the questions and not answering the questions will have no impact on the application process or hiring decisions.  Your responses are not seen by the hiring authority and have zero impact on our decision making process.  Submitting this general application is not an offer of employment and does not a guarantee that the application process will proceed. 
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