Customer Service Representative (Remote - Bilingual)

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Why us?

At Acentra Health, we are a team of experienced and caring leaders, clinicians, pioneering technologists, customer service professionals and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

At Acentra Health, we invest in your skills, offering abundant resources and opportunities for professional development and personal growth. As a rapidly growing national quality improvement and care management organization, we genuinely care about the communities we serve and actively contribute to their well-being. We believe in providing you with the opportunity to excel in your areas of expertise, allowing you to shine at what you do best. Our commitment to continuous learning, development, and fostering career growth ensures that you can reach your full potential and thrive in your professional journey!

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

We do this through our People.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits are a key component of your rewards package. Our benefits are designed to provide you additional protection, security, and support for both your career and your life away from work. We offer competitive salaries/pay, fantastic benefits including comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

Customer Service Representative (Bilingual - Remote)

Position Overview

The Customer Service Representative is responsible for supporting the prior authorization process by answering incoming telephone calls, resolving customer questions, complaints and requests while adhering to internal policies and procedures and utilizing working knowledge of the organization’s services to meet productivity and quality standards.

Role Responsibilities

In this role, you will

• Develop and maintain a deep understanding of internal policies, procedures, and services, both departmental and operational.
• Efficiently utilize automated systems for information retrieval and accurately perform data entry for electronic faxes.
• Handle inquiries from customers or providers via telephone, email, fax, or mail, ensuring timely and accurate responses within specified turnaround times.
• Respond to telephone inquiries and complaints promptly, accurately, and courteously, adhering to standard operating procedures.
• Interact professionally with hospitals, physicians, beneficiaries, and program recipients.
• Investigate and resolve customer issues, escalating complex situations to the appropriate parties when necessary.
• Meet or exceed call volume and service level standards per department guidelines.
• Initiate files by collecting and entering demographic, provider, and procedure information into the system.
• Act as a liaison between Review Supervisors and external providers.
• Maintain logs and documents detailing the disposition of incoming and outgoing calls.

Basic Qualifications

To thrive in this role, you should have

• 2+ years of customer service/telephone experience in a similar call center environment and/or industry.
• A background in medical terminology courses is beneficial.
• Knowledge of medical terminology or experience in the health insurance industry is preferred.
• Fluency in spoken English, ensuring clear communication over the telephone.
• Proficiency in using phone systems and navigating electronic equipment and systems.
• The ability to multitask on a personal computer while handling telephone conversations.
• Experience in a fast-paced call center environment, demonstrating composure under pressure.
• Exceptional verbal and listening skills to deliver courteous and professional customer service.
• Effective PC skills, includ