The role requires communication between medical providers and our clientas well as members. The customer service rep is to coordinate treatment and provide authorizations/issue GOP's for members in Latin America, Europe, etc. Respond to inquiries pertaining to authorizations and documentation requirements.
Responsibilities and Duties:
Coordinate and determine approvals, eligibility and inform the medical providers as well as issue GOP's according to policy and client authorizations
Tracking and follow up of all cases in Latin America ensuring appropriate follow up with the medical providers
Provide guidance, support and advice to international members seeking medical treatments or procedures
Responds to routine phone inquiries and written correspondence related to authorizations and claims status
Screens and routes complex cases to the appropriate manager
Navigates multiple systems to obtain necessary data to issue GOP's
Verify payments and/or denials as well as treatment authorization status and inform the appropriate party accordingly
Able to be a part of a on-call/duties rotating schedule (after normal office hours and weekends)
Qualifications:
Bilingual /English and Spanish required Portuguese/French a plus
2+ years of experience in customer service, health insurance field a plus
High school diploma/GED required
Strong analytical, detail-oriented and accuracy skills are required
Ability to manage time effectively, set priorities, meet deadlines as well as adapt to change
Desire to work in a small entrepreneurial environment