Randstad Hiring for Call Center Customer Service Representative at United States Full Time

Remote Call Center Representative – Specialty Lines Prior Authorization (Oncology and Cardiology)

• 6 month assignment with potential to extend or convert
• Training 6:30a-3p Pacific for 3-4 weeks
• Shift hours range from 5am-5pm Pacific
• Start Date: 12/18

Must have experience in Oncology, Cardiology and/or Pharmacy authorizations

Responsibilities:

– Inbound and Outbound Calls:

– Handle incoming calls for oncology and cardiology prior authorization requests.

– Initiate outbound calls to gather essential information from healthcare providers.

– Prior Authorization Processing:

– Review and evaluate prior authorization requests specific to oncology and cardiology.

– Verify patient information, insurance coverage, and medical necessity within these specialties.

– Documentation and Data Entry:

– Accurately document interactions and pertinent information in the company’s database.

– Ensure precise data entry for oncology and cardiology prior authorization requests.

– Specialty Knowledge:

– Develop and maintain a profound understanding of oncology and cardiology procedures, medications, and treatment protocols.

– Stay updated on the latest medical guidelines and insurance policies relevant to these specialties.

– Customer Service Excellence:

– Provide exceptional customer service with a specialized focus on oncology and cardiology.

– Educate callers about the prior authorization process specific to these medical specialties.

– Adherence to Compliance Standards:

– Strictly adhere to healthcare compliance standards and regulations, particularly in the context of oncology and cardiology.

– Maintain the highest level of confidentiality for patient and provider information.

– Team Collaboration:

– Collaborate with cross-functional teams, including oncologists, cardiologists, claims specialists, and other departments.

– Ensure a comprehensive approach to prior authorizations in oncology and cardiology.

– Performance Metrics:

– Meet or exceed performance metrics specific to oncology and cardiology, ensuring accurate and timely processing.

– Engage in ongoing training to stay abreast of advancements and changes in these medical specialties.

**Qualifications:**

– Education: High school diploma or equivalent; additional healthcare-related certifications are a plus.

– Experience: Previous call center experience with a focus on healthcare prior authorizations or medical insurance, specifically in oncology and cardiology.

– Skills: Excellent communication skills, strong attention to detail, proficiency in data entry, and familiarity with relevant software and databases.

**Working Conditions:**

– Location: Fully remote position.

– Equipment: Reliable internet connection, a dedicated workspace, and the necessary equipment provided by the employer.

– Schedule: Flexible scheduling based on business needs.