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Assoc Service Ops Spec
at Coventry Health Care, Inc. in Pennsylvania
Your Standard is Excellence
You've been looking for an opportunity to work with people who share your commitment to a higher standard. You imagine building a career and even enjoying your work.
Good News.
We've been looking for you, too!
Coventry Health Care is a leader in the managed care industry. Great people enable us to provide service that differentiates us from the competition. We offer a highly rewarding professional environment built around meaningful assignments, collaborative work environments and excellent training and development opportunities. We are a Fortune 500 company, and are proud to have also been named to Forbes Platinum 400 and Barrons 500.
At Coventry Health Care, you'll have the opportunity to collaborate with talented and dedicated professionals while developing and expanding your career. Consider building a career with us!
Associate Service Operations Specialist
GENERAL SUMMARY
Responsible for one aspect of service including, but not limited to, processing claims, adjustments, enrollment and eligibility records, and Medicare Set Aside (MSA) referrals, reviewing, acknowledging and reporting receipt of client files, responding to customer inquiries, and resolving customer concerns within a team environment to meet or exceed customer service requirements.
ESSENTIAL RESPONSIBILITIES
- Processes basic claims, enrollments, and/or adjustments in accordance with company policies and procedures in a timely manner that meets or exceeds productivity and quality goals.
- Researches customer information in response to inquiries including, but not limited to, authorizations, payments, denials, coordination of benefits and enrollment, eligibility, and Medicare Set Aside (MSA) referrals.
- Assesses, investigates and resolves outstanding issues to achieve customer satisfaction.
- Interfaces with customers by telephone and/or correspondence to respond to inquiries and resolve concerns.
- Reconciles all returned checks in a timely and accurate manner.
- Processes and maintains enrollment and eligibility records by ensuring enrollment applications are complete, entering the information into the enrollment system, and resolving basic enrollment system rejections.
- Monitors account receivables records including claims and overdue invoices; implements collection procedures.
- Acknowledges the receipt of client files; reviews, and completes a daily report on the status of client files.
- Takes responsibility for own self-development; recommends areas where cross-training is needed.
- Promotes a positive team environment; seeks out ways to continuously improve teaming.
- Understands the team's performance against measured service operation goals; accepts ownership for individual and team results; identifies and initiates process improvements.
Performs other duties as required.
JOB SPECIFICATIONS
- High school degree or equivalent.
- Ability to maintain production levels and quality goals.
- Customer service and/or team experience preferred.
- Knowledge of health care products, medical terminology, diagnosis and
procedure coding, and coordination of benefits.
- Ability to establish and maintain effective working relationships.
- Excellent organizational, interpersonal, communication and problem solving
skills.
- Required to pass a battery of job-related tests administered prior to
employment.
It's easy to build your career at Coventry.
Visit our website where you can view our open positions and learn more about your next opportunity with Coventry!
http://careers.cvty.com
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://coventry.contacthr.com/16076676
You've been looking for an opportunity to work with people who share your commitment to a higher standard. You imagine building a career and even enjoying your work.
Good News.
We've been looking for you, too!
Coventry Health Care is a leader in the managed care industry. Great people enable us to provide service that differentiates us from the competition. We offer a highly rewarding professional environment built around meaningful assignments, collaborative work environments and excellent training and development opportunities. We are a Fortune 500 company, and are proud to have also been named to Forbes Platinum 400 and Barrons 500.
At Coventry Health Care, you'll have the opportunity to collaborate with talented and dedicated professionals while developing and expanding your career. Consider building a career with us!
Associate Service Operations Specialist
GENERAL SUMMARY
Responsible for one aspect of service including, but not limited to, processing claims, adjustments, enrollment and eligibility records, and Medicare Set Aside (MSA) referrals, reviewing, acknowledging and reporting receipt of client files, responding to customer inquiries, and resolving customer concerns within a team environment to meet or exceed customer service requirements.
ESSENTIAL RESPONSIBILITIES
- Processes basic claims, enrollments, and/or adjustments in accordance with company policies and procedures in a timely manner that meets or exceeds productivity and quality goals.
- Researches customer information in response to inquiries including, but not limited to, authorizations, payments, denials, coordination of benefits and enrollment, eligibility, and Medicare Set Aside (MSA) referrals.
- Assesses, investigates and resolves outstanding issues to achieve customer satisfaction.
- Interfaces with customers by telephone and/or correspondence to respond to inquiries and resolve concerns.
- Reconciles all returned checks in a timely and accurate manner.
- Processes and maintains enrollment and eligibility records by ensuring enrollment applications are complete, entering the information into the enrollment system, and resolving basic enrollment system rejections.
- Monitors account receivables records including claims and overdue invoices; implements collection procedures.
- Acknowledges the receipt of client files; reviews, and completes a daily report on the status of client files.
- Takes responsibility for own self-development; recommends areas where cross-training is needed.
- Promotes a positive team environment; seeks out ways to continuously improve teaming.
- Understands the team's performance against measured service operation goals; accepts ownership for individual and team results; identifies and initiates process improvements.
Performs other duties as required.
JOB SPECIFICATIONS
- High school degree or equivalent.
- Ability to maintain production levels and quality goals.
- Customer service and/or team experience preferred.
- Knowledge of health care products, medical terminology, diagnosis and
procedure coding, and coordination of benefits.
- Ability to establish and maintain effective working relationships.
- Excellent organizational, interpersonal, communication and problem solving
skills.
- Required to pass a battery of job-related tests administered prior to
employment.
It's easy to build your career at Coventry.
Visit our website where you can view our open positions and learn more about your next opportunity with Coventry!
http://careers.cvty.com
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://coventry.contacthr.com/16076676
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