Note: The job is a remote job and is open to candidates in USA. WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation serving clients across multiple industries, including healthcare. The Client Service Representative supports HealthHelp’s Clinical Review process by conducting administrative and scripted clinical intake, assisting providers and office staff, maintaining confidential records, and delivering quality customer service. The role also supports quality initiatives, compliance requirements, and performance objectives.
Responsibilities
- Conducts administrative intake and scripted clinical intake of calls for clinical review
- Provides quality customer service through interaction with providers, administrative staff and others
- Builds and maintains customer satisfaction with products and services; provides excellent service to internal and external customers
- Collects and enters confidential information ensuring the highest level of confidentiality in all areas
- Maintains high-quality documentation standards when collecting and performing data entry functions
- Provides ongoing telephonic support to providers and office staff related to HealthHelp’s Clinical Review process
- Provides administrative support to the Clinical Review Department if needed
- Participates and understands scope of responsibility pertaining to ongoing Quality Initiative Projects
- Maintains acceptable levels of performance for all Key Performance Indicators, such as Average Talk Time (ATT), Quality, and adherence to schedule
- Participates in the HealthHelp Quality Management Program as required
- Adheres to all HIPAA, state and federal regulations pertaining to the clinical programs
- Adheres to both URAC & NCQA standards in keeping with HealthHelp’s compliance initiatives
- Carries out other projects and responsibilities as assigned
Skills
- High School Diploma/GED, required
- Minimum One (1) year of Healthcare customer service (call center) experience required
- Ability to hard line internet into computer equipment provided, required
- Internet upload speed of 5 mbps and download of 25 mbps, required (verified at onboarding)
- Ability to adhere to strict schedule with ability to adapt to schedule changes, as schedules are subject to change, required
- HIPAA compliant room, required (verified at onboarding)
- Prior experience in the healthcare industry (i.e., prior authorizations, patient care, CPT codes, etc.), preferred
- Ability to read clinical terminology with high levels of proficiency
- Ability to work efficiently in a fast-paced, high call volume, performance driven Contact Center
- MS Outlook and Windows proficiency
- Ability to work on dual monitors and navigate multiple software applications simultaneously
- Strong time management skills
- Highly skilled at delivering client and customer satisfaction
- Must possess strong verbal and written communication skills
- Ability to wear a headset for 8 hours a day, required
- Ability to respond quickly to instructions in a fast-paced work environment, required
- Ability to talk without voice restrictions for 8 hours a day, required
- Ability to sit for extended periods of time without a break, required
- Prior experience in a fast-paced in-bound call center environment, preferred
Benefits
- Medical, dental, and vision insurance
- Paid time off (PTO), holidays, and sick leave
- 401(k) with company match or other retirement plan
- Life and AD&D Insurance
- Employee Assistance Program
- This role may be eligible for performance-based bonuses, incentive pay, or commissions
Company Overview