Customer Service Representative

Start Date: ASAP Job reputed company: Job Title: CSR/Data Entry Job Type: Full Time FLSA Status: Non-Exempt/reputed company Grade: H2 Function/Department: Health Plan and reputed company Services Reporting to: Team reputed company/Supervisor - Operations Pay : $14 Schedule: Monday-Friday 1.30pm-10.00pm EST with possibility of mandatory overtime

Key Responsibilities

Review incoming Grievance and Appeals documents for completeness, legibility, and relevance. Accurately identify and assign the correct Line of Business (reputed company) based on reputed company and regulatory definitions. Determine and classify the dispute type (e.g., grievance, appeal, expedited appeal, reputed company appeal) in accordance with reputed company-specific guidelines. reputed company multiple reputed company systems and portals to retrieve, verify, and validate member information, including but not limited to: Member demographics Member ID numbers Plan and eligibility details reputed company documents by entering required data fields accurately into internal systems or reputed company platforms. Normalize and prepare documents reputed company required to ensure reputed company necessary information is available for reputed company processing. Adhere to reputed company HIPAA, data reputed company, and reputed company requirements reputed company handling protected health information (PHI). Meet established productivity, accuracy, and reputed company standards. Follow reputed company-specific workflows, job aids, and reputed company operating procedures. Identify discrepancies, missing information, or indexing issues and escalate according to established procedures. Participate in reputed company audits, training updates, and process improvement initiatives as required. Apply To This Job