Description
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary This position is responsible for direct supervision of the customer service representative, clinical review analyst, medical record assistant, and system interface analyst staff in the customer care call center. Also responsible for the evaluation of service levels, staff education, and special projects. Response to claim inquiries, waiver requests both clinical and geographic, level iii claim check review, clinical retrospective medical reviews, and network steerage of members/providers. Drafting, editing, and annual review of the departmental internal policies and procedures relative to workflows and processes for compliance with accreditation and recent legislation. Ensuring all training materials are updated and reflect the current practices with the department. And assisting in the direction, coordination and managing of the internal administrative functions adhering to the service and the financial goals established for the department.**This is a work from home position in Texas**
**You must live in Texas for this role**
Required Job Qualifications:
*Bachelor Degree in Health Care Administration, Business Administration, or 4 years experience in the health care industry.
*3 years experience in health insurance and health care delivery and financing.
*2 years supervisory experience in a call center or in a lead role
*Knowledge of managed care program policies and procedures.
*Knowledge of health care delivery and financing systems, and financial techniques.
*Knowledge of ACD telephone systems and telephone tiering.
*Clear and concise interpersonal, verbal and written communication skills.
*PC proficiency to include Word, Excel, PowerPoint and Lotus Notes
Preferred Job Qualifications:
*Clinical Experience
Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.
#LI-Remote
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
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