Customer Service Associate

hace 3 horas

Ciudad de México UST A tiempo completo

**Customer Service Associate**

**Associate III - BPM
**Who we are**:
UST HealthProof is a dynamic company with a mission to lower the cost of care and deliver the future of healthcare. Our consumer-centric approach gives our health plan customers a modern infrastructure and reduced administrative costs, helping to drive better business results for our customers — and better outcomes for our communities.

**You Are**:
Reporting to the Customer Service Manager, the Customer Service Associate will provide exceptional customer service to the UST customers via inbound Call Center Operations. Associate will mentor new call center agents as well as support the improvement of peers. The service center will be open from 8am-6pm CST USA and will occur related schedules.

**The Opportunity**:

- Receive and respond to inbound phone calls for customer assistance
- Be a peer mentor
- Take escalated calls and issues as experience dictates
- Respond to outbound phone call requests
- Document all calls in ticketing and tracking systems
- Respond to customer inquiries and provide data to customers within a required time frame
- Act as liaison between claims department and providers
- Research customer claims in the primary payor systems
- Ensure highest level of customer service on every call Maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

**What you need**:

- High school degree required; Bachelor’s degree preferred with three (3) plus years of relevant professional experience in Healthcare claims operations for a large national/regional or Blues health plan or insurance company and/or TPA.
- Previous Health Care Call Center/Customer Service Experience.
- Desired Skills include: Knowledge of physician practice and hospital coding, billing and medical terminology
- Experience with UB/Institutional (UB04); Professional (CMS1500) claims and HIPAA-compliant EDI formats for claims related exchanges. Understand CMS guidelines for claims processing.
- Must be able to work with mínimal supervision.
- Excellent verbal and written communication skills.

**What we believe**:
We’re proud to embrace the same values that have shaped UST HealthProof since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone, to champion diversity and inclusion, and to place people at the center of everything we do.

**Humility**:
We will listen, learn, be empathetic and help selflessly in our interactions with everyone.

**Humanity**:
Through business, we will better the lives of those less fortunate than ourselves.

**Integrity**:
We honor our commitments and act with responsibility in all our relationships.

**Equal Employment Opportunity Statement
**UST HealthProof 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, or status as a protected veteran.

UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

USTHealthproof

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