Responsible for implementing and optimizing IVR technology and CX platforms for new and existing clients. This includes managing technical troubleshooting, creating workflow documentation, and analyzing platform utilization metrics to improve self-service rates.
SKYGEN
9 Remote Job Openings at SKYGEN
Responsible for complex administrative functions within the Authorizations Department, including handling escalated customer inquiries and managing authorization schedules. The role involves monitoring quality, leading training for new team members, and acting as a liaison during new client implementations.
Oversee the credentialing department to ensure providers are credentialed accurately and timely while serving as a subject matter expert in commercial insurance. Lead and develop staff, implement departmental procedures, and ensure alignment with NCQA and regulatory guidelines.
Provide customer support for dental and vision insurance callers regarding eligibility, benefits, and claims. Act as a liaison between the organization and member services to resolve issues and educate providers on using the web portal.
Customer Care Representatives will service inbound callers regarding their eligibility, benefit coverage, and claims. They will also act as a liaison between the organization and clients to resolve issues and provide updates.
Supervise a team of 15-20 customer care representatives to ensure high service levels and adherence to department guidelines. Responsibilities include coaching staff, managing daily call center operations, and handling escalated customer concerns.
Oversee the Claims Intake department by leading a team of 12-15 reports to ensure accurate and timely business operations. Act as a subject matter expert to resolve escalated issues and implement process improvements to meet client SLAs.
Educate members and providers on using web-based portals for claims, payments, and authorizations. Act as a liaison between users and clients to resolve issues and provide feedback for system enhancements.
The specialist will identify prospects and recruit providers using effective techniques to meet contractual requirements, while also performing daily tasks like running access reports and conducting market analysis on new areas. Daily activities involve making prospecting calls to educate providers on network benefits and reimbursement levels, and conducting negotiations to build and maintain the provider network.