Customer Service Representative (on-site in Cheyenne, Wyoming)

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Customer Service Representative to join our growing team.

Job Summary

Are you passionate about making a difference and providing exceptional customer service? Join our team as a Customer Service Representative, where you will be a crucial part of Wyoming Benefits Management System and Services (WY BMS). In this front-line role, you will support members and providers by addressing inquiries related to programs, policies, and procedures, ensuring a seamless and positive experience. You will be responsible for handling incoming calls from members and providers, providing clear and professional answers to questions about eligibility, benefits, claims, and service authorizations.

As a Customer Service Representative, you will accurately document intake information into appropriate systems, ensuring thorough and precise records are maintained. Strive to resolve member and provider needs on the first call, delivering exceptional service to both internal and external customers. Consistently meet operations production and quality standards, showcasing your commitment to excellence in every interaction. This role is 100% onsite position.

Job Responsibilities

• Available to work an 8-hour shift from 7:00 AM to 6:00 PM Mountain Time, Monday through Friday, excluding Wyoming State holidays.
• Accurately respond to inbound phone calls and process provider and member inquiries and requests into the appropriate system and database.
• Resolve customer service or billing complaints under general supervision by demonstrating sound judgment.
• Contact customers to address complex inquiries or inform them of claim investigation results and any planned adjustments.
• Resolve customer administrative concerns as the first line of contact, including claim resolutions and other expressions of dissatisfaction.
• Refer unresolved customer grievances, appeals, and claim resolutions to designated departments for further investigation.
• Maintain detailed records of customer interactions and transactions, recording inquiries, complaints, comments, and actions taken.
• Actively listen to and probe callers in a professional and timely manner to determine the purpose of their calls.
• Research and communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries while maintaining confidentiality.
• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal).
• Educate providers on claim submission processes and the appropriate steps for submitting treatment plans.
• Perform necessary follow-up tasks under general supervision to ensure member or provider needs are completely met.
• Support team members and participate in team activities to help build a high-performance team.
• Maintain detailed logs and document the disposition of incoming and outgoing calls, ensuring accurate record-keeping.
• Document customers' comments and information, forwarding required information to the appropriate staff.
• Escalate calls to the Call Center Lead when necessary.

Requirements

Required Skills, Qualifications, and Experience:

• High School diploma or equivalent.
• Minimum 2 years of customer service-related experience required.
• Strong verbal and written communication skills, with strong attention to detail and customer service abilities.
• Proficient typist (average 35+ WPM) with strong written and verbal communication skills.
• Excellent interpersonal skills to effectively interact with customers and team members.
• Responsible for meeting call handling requirements and daily telephone standards as set forth by management
• Proficiency in accurately documenting and recording customer/client information.
• Previous experience with computer applications, such as Microsoft Office Suites; Word, Outlook, Excel, and PowerPoint.
• Ability to work independently and manage one’s time efficiently.
• Must be flexible in scheduling and adaptable to change, as customer service is an ever-changing environment.
• Must be able to maneuver through various computer platforms while verifying information on all calls.
• Must be able to talk and type simultaneously.

Preferred Qualifications (Nice to Have):

• Knowledge of medical terminology and/or experience in the health insurance industry.
• Bilingual proficiency in Spanish and English.

Why us

We are a team of experienced and caring leaders, clinicians, pioneering technologists, 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. 

We do this through our people

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career. 

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The compensation for this role is $16.20 to $20.00 per hour.

Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.