Communication Center Representative (Hybrid)

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

This is a HYBRID position.

About this position:

Location: Hybrid  (Within US Only)

• Onsite: Monday/Wednesday/Friday 9:00 AM - 5:00 PM CST, (6509 Windcrest Drive, Suite 165, Plano, Texas 75024)
• Remote:  Tuesday/Thursday 9:00 AM - 5:00 PM CST

The WISeR Communication Center Representative serves as the primary point of contact for providers, facilities, and internal partners seeking support with WISeR workflows. This role is responsible for delivering timely, professional, and empathetic customer service while assisting with prior authorization requests, case status inquiries, documentation intake, and portal navigation.

The ideal candidate is detail‑oriented, calm under pressure, and committed to creating a positive customer experience while supporting compliance‑driven healthcare processes.

• Respond to inbound inquiries via phone, email, portal, and fax regarding WISeR cases and prior authorization requests.

• Provide clear, courteous updates on case status, next steps, and estimated turnaround times.

• Educate customers on submission options (portal, fax, alternate workflows) to help prevent delays in patient care.

• De‑escalate concerns professionally and route issues appropriately when escalation is needed.

• Review incoming requests for completeness and accuracy.

• Assist with documentation intake and routing to the appropriate WISeR queue.

• Identify submission issues related to NPI, PTAN, UTN, or enrollment details and communicate corrective guidance.

• Document all customer interactions accurately in internal systems.

• Collaborate with WISeR clinical, admin, and management teams to support timely case resolution.

• Escalate cases following established escalation guidelines when SLA or impact criteria are met.

• Track follow‑ups and ensure customers receive consistent and accurate information.

• Adhere to HIPAA and data privacy requirements when handling PHI and sensitive information.

• Follow internal policies and standard operating procedures (SOPs).

• Contribute to continuous improvement by identifying recurring issues and suggesting process enhancements.

• Support maintenance of knowledge base articles and customer guidance materials.

• High school diploma or equivalent required (Associate’s or Bachelor’s degree preferred).

• 1–3 years of customer service experience, preferably in healthcare, insurance, or revenue cycle environments.

• Strong verbal and written communication skills.

• Ability to manage multiple tasks in a fast‑paced, metrics‑driven environment.

• High attention to detail and documentation accuracy.

• Comfort working with portals, case management systems, and Microsoft Office tools.

• Experience with prior authorization, utilization management, or medical review workflows.

• Familiarity with Medicare Part A / Part B concepts.

• Experience supporting providers or facilities in a healthcare operati