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KEPRO Customer Service Representative - Hybrid role in Cary, North Carolina in Cary, North Carolina

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Customer Service Representative

Are you an experienced Customer Service Representative looking for a new challenge?

Are you motivated, energetic, and excited to become part of the Acentra Health team?

If so, you might be our next new team member!

Position Overview

Join our team as a Customer Service Representative and become an essential player in the vital prior authorization process. In this dynamic role, you will be the first point of contact for our customers, handling incoming calls with a blend of professionalism and care. Your day-to-day responsibilities will include responding to customer inquiries, resolving complaints, and fulfilling requests with precision and adherence to our strict internal policies and procedures.

Your role is not just about answering calls—it's about creating a positive impact with every interaction. With your deep understanding of our organization's services, you will be equipped to offer solutions and support that go beyond the ordinary, striving not only to meet but to exceed productivity and quality standards. This position offers the opportunity to develop your communication and problem-solving skills in a supportive and fast-paced environment. As part of our customer service team, your contributions will be key to maintaining the high level of customer service. If you are ready to take on a role that challenges and rewards you, enhancing our company's commitment to outstanding customer support, we look forward to your application.

Job Responsibilities:

  • Develop and maintain a comprehensive understanding of internal policies, procedures, and services, encompassing both departmental and operational aspects.

  • Efficiently utilize automated systems for logging and retrieving information, ensuring accurate and timely data entry for electronic faxes.

  • Handle inquiries from customers or providers through various channels such as telephone, email, fax, or mail, delivering responses within specified turnaround times.

  • Respond to telephone inquiries and complaints promptly, accurately, and courteously, strictly adhering to standard operating procedures.

  • Engage with hospitals, physicians, beneficiaries, and other program recipients to facilitate effective communication.

  • Investigate and resolve customer problems, escalating challenging situations to the appropriate party when necessary.

  • Meet or exceed standards for call volume and service level as per department guidelines.

  • Initiate files by collecting and entering demographic, provider, and procedure information into the system.

  • Act as a liaison between Review Supervisors and external providers, fostering collaborative relationships.

  • Maintain detailed logs and document the disposition of incoming and outgoing calls, ensuring accurate record-keeping.

Required Skills, Qualifications, and Experience:

  • High School diploma or equivalent.

  • Completion of medical terminology course(s) is beneficial.

  • Minimum of 2 + years of customer service/telephone experience in a similar call center environment and/or industry.

  • Proficient verbal and listening skills, ensuring courteous and professional customer service.

  • Effective PC skills, including proficiency in electronic mail, intranet, and industry-standard applications.

  • Fluent in English with clear telephone communication abilities.

  • Competent use of phone systems.

  • Strong research and investigative skills.

  • Familiarity with medical terminology is advantageous.

  • Adherence to confidentiality policies and procedures.

  • Ease in navigating and utilizing electronic equipment and systems.

  • Ability to multitask on a personal computer while engaging in telephone conversations.

  • Capability to work efficiently in a fast-paced call center environment.

  • Demonstrated ability to remain calm and courteous when handling challenging calls and requests.

Additional Qualifications (Nice to Have):

  • Successful completion of medical terminology course(s).

  • Knowledge of medical terminology and/or experience in the health insurance industry.

  • Bilingual proficiency in Spanish and English.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The compensation for this role is $17.50 - $19.00 per hour and comprehensive benefits. Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level. Thank You.

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search.

The Acentra Health Talent Acquisition Team

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