CNSI and Kepro are now Acentra Health! 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 company’s mission, actively engage in problem-solving, and take ownership of your work daily. 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.

 

Acentra seeks a Customer Service Representative to join our growing team.

Job Summary:

The purpose of this position is to answer incoming telephone calls, and resolve customer questions, complaints and requests while adhering to internal policies and procedures and utilizing working knowledge of the organization’s services to meet productivity and quality standards.  

*Position is hybrid. Candidates are expected to be able to travel to the Charleston, WV office once a week. Candidates living within 30 miles of Charleston are preferred. 

 

Job Responsibilities:

Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational).   Utilize automated systems to log and retrieve information; Perform accurate and timely data entry of electronic faxes.  Receive inquiries by telephone, email, fax, or mail and communicates response within required turnaround times.   Respond to telephone inquiries in a prompt, accurate, and courteous manner following standard operating procedures. Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients.   Perform verification of healthcare services to facilitate payment for received services. Identify medical claims meeting CPT/DRG audit criteria and submits the necessary billing data and healthcare records to the third-party auditor.  Serve as liaison between the internal and external partners. Investigate and resolve or report provider problems, and identify and escalate difficult situations to the appropriate party. Meet or exceed standards for call volume and service level per department guidelines.  Initiate cases by collecting and entering demographic, provider, and procedure information into the system.   May be responsible for the completion of daily, monthly, and quarterly reports necessary for the clinical team operations and client reporting.