Position Summary
Customer Service Professionals (CSP’s) on the Electronic team are responsible for supporting client retention and PT referral objectives by consistently handling new EOC/case requests from all sources including Adjuster, NCM, Payer, TPA, Doctor, Employer, Provider (Center) and Patients. The new EOC/case opening are all conducted electronically meaning by Email, Fax, Adjuster Portal, MM package receipt and EDI process. Productivity and quality of work are of equal importance.
Primary Duties & Responsibilities
- Receive inbound electronic referrals from Adjusters, NCMs, Centers, MDs, patients etc.
- Open new EOCs/cases accurately according to policy and procedures.
- Review case information to determine if a new case needs to be opened or patient can be followed in existing case.
- Make first outbound attempts with various sources to verify new case/missing information, requesting Verification from Insurance Carriers or request other related paperwork telephonically
- Maintain productivity and quality EOC monitoring goals daily/monthly.
- Validate new case data by reviewing, correcting, deleting, or re-entering data; combining data when account information is incomplete.
- Phone trained CSPs with prior MedRisk Inbound call center experience will be called upon to assist with incoming calls during a time of crisis.
- Forward any email/fax to proper dept. Attachment documents appropriately to new/existing EOCs.
- Understand MedRisk’s interdepartmental procedures, policies and comply with them.
- Identify potential or existing system and/or procedural challenges, and notify Supervisor and assist in resolution if needed.
- Complete special projects or tasks as assigned by the supervisor.
- Compliance with HIPPA and URAC guidelines
- Other duties as assigned.
Qualifications
- Bachelor’s Degree preferred or industry experience equivalent
- Excellent verbal and written customer service skills demonstrating a can-do attitude.
- Highly developed problem-solving skills.
- Strong data entry skills
- Detail oriented and solid organizational skills
- Solid MS Word, Excel and Outlook experience
- Must have ability to multi-task and work independently
Skills Required
- Bachelor's degree or equivalent industry experience
- Excellent verbal and written customer service skills
- Highly developed problem-solving skills
- Strong data entry skills
- Detail-oriented and organized
- Experience with Microsoft Word, Excel, and Outlook
- Ability to multitask and work independently
What We Do
Founded in 1994 and headquartered in Conshohocken, Pennsylvania, MedRisk was established with a mission to revolutionize physical rehabilitation for workers' compensation patients. Over the last 30 years, the company has evolved into a leading managed care organization dedicated to physical rehabilitation and medical bill review for the casualty claims industry.
