Call Center Representative - Healthcare (Hybrid - Nashville, TN)
 Acentra Health | |
paid time off, remote work
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 United States, Tennessee, Nashville | |
 Mar 07, 2025 | |
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Company Overview
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Call Center Representative - Hybrid (within Nashville, Tennessee) to join our growing team.
Job Summary:
* Role: Call Center Representative
* Function: Front-line service position aiding state benefit system members and providers regarding programs, policies, and procedures.
* Responsibilities: Answering inbound and outbound calls related to eligibility, benefits, claims, and authorization of services.
Responsibilities:
* Work Schedule: Available to work scheduled hours based on operational needs.
* Call Handling: Accurately respond to inbound and outbound calls and process providers and members inquiries.
* Complaint Resolution: Resolve member's service or billing complaints, under general supervision, by demonstrating sound judgement.
* Customer Contact: Respond to complex inquiries and notify customers of claim investigation results.
* Grievance Referral: Refer unresolved grievances, appeals, and claim resolutions to designated departments.
* Record Keeping: Maintain records of customer interactions and transactions.
* Active Listening: Actively listen and probe callers to determine the purpose of the calls.
* Research: Research and communicate information regarding member eligibility and claims status.
* Self-Development: Assume responsibility for self-development and career progression.
* Provider Education: Educate providers on claim submission and treatment plan procedures.
* Follow-Up: Perform necessary follow-up tasks to ensure member or provider needs are met.
* Team Support: Support team members and participate in team activities.
* Policy Adherence: Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.
Work Schedule, Work Arrangement and Training for this role:
* Work Schedule:
o 7:00 AM to 5:00 PM Central, Monday through Friday
o Excludes Company-observed Holidays
* Work Arrangement:
o Hybrid role
* Mondays and Wednesdays: Work from the Nashville, Tennessee office
* Tuesdays, Thursdays, and Fridays: Work from home
o The selected candidate must have a dedicated, private, and secure workspace at home, free from distractions, to ensure productivity and confidentiality, and with reliable internet service. * Training:
o Six-week training session
o 8:30 AM to 5:00 PM Central, Monday through Friday
o Excludes Company-observed Holidays Qualifications Required Qualifications/Experience:
* Education: A minimum of a High School Diploma OR GED equivalent (or higher level of education).
* Technical Skills: Intermediate proficiency with Microsoft Office Word, Outlook and Teams, and Beginner proficiency with Excel and PowerPoint.
* Experience:
o 1+ years of customer service experience in a healthcare call center environment.
o 1+ years of experience utilizing Medical Terminology. * Clinical Codes Experience: o 1+ years of experience with HCPCS.
o 1+ years of experience with CPT codes.
o 1+ years of experience with ICD-10 codes. Preferred Qualifications/Experience:
* Coursework: Medical terminology course(s).
*
Communication Skills:
Strong verbal and written communication skills. * Attention to Detail: High attention to detail.
* Customer Service Skills: Excellent customer service skills.
* Independence: Ability to work independently and manage time effectively.
* Documentation: Ability to accurately document and record customer/client information. 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 pay range for this position is listed below. "Based on our compensation philosophy, 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! 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 Visit us at Acentra Health EEO 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. Pay Range USD $12.37 - USD $20.00 /Hr. | |