Title-Customer Service III Duration-5 Months Location-30 S Keller Road, Suite 100B, Orlando, FL 32810 Shift- 8:00 am - 5 pm
Job Description: • Initiates Pre-authorization, PCP referral and Letter of Agreement requests for new and ongoing services with insurance companies and performs follow up activities for an outcome. • Files Appeals for denied coverage to insurance companies as needed. • Maintains customer records in practice management system related to benefit coverage, coordination of benefits, authorizations, denials, appeals, outcomes and communication with insurance company. • Coordinates and communicates with other departments as needed to obtain necessary information to complete benefit verification, authorization, appeals and outcomes for services of care. • Provides customers with information that includes but is not limited to: updates on status of authorizations, developing & communicating patient financial responsibility estimates, and collecting co-pays, if applicable. • Applies knowledge of company procedures, contracted and non-contracted guidelines to process cases accordingly and to respond to incoming correspondence and documentation as well as updating customer records according to outcomes. • Performs other related duties as assigned.
Required Qualifications: • High school diploma or GED required • Preferred two or more years’ experience, but a minimum of 1 year experience is required in insurance benefits verification and/or collections and/or managed care contracting. • Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers. • Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service • Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices • Understand the process for verification of benefits or collections as it relates to the policies and procedures for effective placement of medical services. • Complete Understanding of Medicare Rules and Regulations • Understanding of Managed Care as it relates to benefits and authorizations • Advanced MS Office experience, with an emphasis on MS Excel desired • Continued Self Improvement courses & seminars related to position along with “In House” programs provided
Preferred Qualifications: • Associate’s Degree Preferred • Knowledge in Medical Insurance • Knowledge in Contracting and Fee Schedules • Strong Computer/Software Skills
Physical Requirements: • Must be able to work at a computer workstation for extended periods of time
Position is offered by a no fee agency.
Location : 30 S Keller Road, Suite 100B, Orlando, Florida, USA, 32810 About Us: Established in 2004, SPECTRAFORCE® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRAFORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at: http://www.spectraforce.com
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.
Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer.
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $21.21/hr.