Job Description
Job Description
Job Overview: The role requires communication among medical providers, our client, and members. The customer service rep is to coordinate treatment and provide authorizations/issue GOPs for members in Latin America, Europe, etc. Respond to inquiries about authorizations and documentation requirements.
Responsibilities and Duties:
- Coordinate and determine approvals, eligibility, and inform the medical providers, as well as issue GOPs according to policy and client authorizations
- Tracking and follow-up of all cases, ensuring appropriate follow-up with the medical providers
- Provide guidance, support, and advice to international members seeking medical treatments or procedures
- Responds to routine phone inquiries and written correspondence related to authorizations and claims status
- Verify payments and/or denials, as well as treatment authorization status, and inform the proper party accordingly
- Able to be a part of an on-call/duties rotating schedule (after regular office hours and weekends)
Qualifications:
- Bilingual /English and French required
- High school diploma/GED required