Healthcare Customer Service Representative

Healthcare Customer Service Representative at Vega Consulting Solutions

Vega Consulting Solutions is seeking a dedicated Healthcare Customer Service Representative for a 3-month+ project. This role is crucial in supporting the Utilization Management clinical teams by managing non-clinical administrative tasks related to pre-service, utilization review, care coordination, and quality of care. We are looking for candidates located in Maryland, Virginia, or the Washington D.C. area.

Key Responsibilities and Requirements

• Possess 3 years of healthcare experience in claims/service areas or office support.
• Have at least two years of experience within a healthcare or managed care setting.
• Demonstrate knowledge of CPT and ICD-10 coding.
• Experience with Guiding Care is preferred.
• Ability to effectively participate in a multi-disciplinary team, including internal and external participants.
• Exhibit excellent communication, organizational, and customer service skills.
• Knowledge of basic medical terminology and concepts used in managed care.
• Understanding of standardized processes and procedures for evaluating medical support operations business practices.
• Show excellent independent judgment and decision-making skills, consistently demonstrating tact and diplomacy.
• Proficient ability to pay attention to the minute details of a project or task.
• Experienced in the use of web-based technology and Microsoft Office applications such as Word, Excel, and PowerPoint.

Key skills/competency

• Customer Service
• Healthcare Claims
• Medical Terminology
• CPT Coding
• ICD-10 Coding
• Managed Care
• Microsoft Office
• Communication Skills
• Organizational Skills
• Administrative Support