Website https://pm.healthcaresource.com/cs/mercyhealth/#/job/16385

A Passion for Making Lives Better

MercyCare Insurance – Janesville, WI
80 hours/2 weeks
Monday – Friday, Day shift
Experience a rewarding and fulfilling career with Mercyhealth. Mercyhealth is committed to offering our partners a best place to work. Our unique workplace Culture of Excellence is built upon:

Employee engagement, empowerment and growth
Teamwork toward our common goal – providing exceptional health care services with a passion for making lives better
An atmosphere of caring and quality that cascades throughout the organization

ESSENTIAL DUTIES AND RESPONSIBILITIES

Responds to all incoming telephone calls.
Resolves all inquiries in a professional manner consistent with the mission of the health system.
Assist callers with complaints, appeals, grievances and IRO requests.
Attend seminars/training sessions.
Specific responsibilities include all Level 1 Member Service requirements as well as the following: update all SOP’s directly related to any responsibilities of a CSR 1; adding membership to the PBM software; adding authorizations to the PBM software; processing all prescription claims (DMR) through the PBM software;  Respond to 100% of overflow phone calls by the time standards for A.M. and P.M. messages;  Send out delays letters for all complaints within time standards established.
Resolves all concerns of callers that have been forwarded by CSR 1’s.
Performs duties of CSR 1’s as a backup as needed (i.e. absences, lunches, vacations, large call volume).
Assist in the training of CSR 1 employees.
Responsible for resolving complaints within the time standards of the applicable SOP.
Responsible for completion of all customer service functions without close supervision.

EDUCATION & EXPERIENCE

Level 1: Associate’s degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.

Level 2: Bachelor’s degree or two years of experience in the healthcare industry, as related to this position.

SPECIAL PHYSICAL DEMANDS

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.

While performing the duties of this Job, the employee is regularly required to sit, talk and hear. The employee is frequently required to use hands to finger, handle, or feel and reach with hands and arms. Specific vision abilities required by this job include close vision, peripheral vision and ability to adjust focus. The employee is occasionally exerting up to 20 pounds of force. Must use a computer, keyboard, mouse and specific computer programs as required.

 

To apply for this job email your details to ecoleman@mhemail.org

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