Description

NOTE: THIS POSITION HAS THE ABILITY TO WORK REMOTELY UNTIL FURTHER NOTICE!

Innovista Health Solutions is an Illinois-based service organization with management services operations in Illinois and Texas. We are currently looking for a Customer Service Representative in our Oak Brook, IL office. At Innovista, we believe that positive-forward movement in today’s uncertain healthcare market stems from the combination of innovative programs and dedicated people. Join the Innovista team and lead the charge to a better, more efficient healthcare system.

JOB SUMMARY:

Responsible for acting as a liaison between members, health providers and Health Plans. Assists in the resolution of calls: claims questions, billing, complaints, and other queries.

DUTIES AND RESPONSIBILITIES

• Responsible for responding to and timely resolution of all incoming calls on designated customer services’ telephone lines. These phone calls will include but are not limited to the following:
• Member Calls.
• Resolve claim issues.
• Assist in resolution of difficulties with access and telephone availability of physician offices.
• Determine eligibility.
• Health Plan Calls.
• Eligibility and claim inquiries
• Assist in resolution of member complaints
• Provider Office Calls:
• Respond to claim inquiries.
• Verify eligibility and co-payments.
• Maintain documentation of types and number of phone calls.
• Process member and provider correspondence.
• Process incoming faxes received.
• Maintains all necessary levels of member/patient privacy in accordance with HIPAA standards.
• Perform other duties as assigned.

Requirements

• Associate degree or equivalent experience required.
• At least 2-3 years of relevant professional experience, including customer service environment.
• Knowledge of CPT 4, HCPCS and ICD-10 coding and medical terminology.
• Bilingual is a plus.
• Excellent organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytic skills when problem solving.
• Proficient in MS Office Applications and ability to learn department and job specific software systems.
• Demonstrate high attention to detail and a high degree of accuracy.
• Able to commit to Innovista’s corporate mission and values.
• Able to switch priorities in a positive and effective manner when directed by Company leadership.
• Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.

BENEFITS:

Innovista is dedicated to hiring passionate individuals who embody our core values: integrity, determination, and teamwork. We recognize the importance of work-life integration and seek to provide our employees with competitive benefits, which include:

• Comprehensive health plan options, dental, and vision coverage subsidized by Innovista
• Opportunity to work from home, based on position and manager discretion
• Company-paid benefits, such as short- and long-term disability, employee life, and AD&D
• Discretionary bonus
• 401(k) with company match
• Opportunity for career advancement and growth
• Flex time options may be available

We do not post salary ranges. Salary ranges posted on other sites are not tied to our labor market specifications and are not relevant.