USFHP, Customer Service Representative

Employer
Johns Hopkins Medicine
Location
Glen Burnie, MD
Posted
Apr 20, 2017
Closes
Apr 21, 2017
Function
Customer Service
Industry
Other
Hours
Full Time
**USFHP, Customer Service Representative** Apply Johns Hopkins Health Care, Glen Burnie, MD Requisition # **151672** Day Shift Full Time (40 hours) Weekend Work Not Required Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here. **Jointly owned by the Johns Hopkins Health System and the Johns Hopkins University School of Medicine, Johns Hopkins HealthCare (JHHC) develops and manages medical care contracts with organizations, government programs, and health care providers for more than 300,000 plan members. One of our lines of business is a TRICARE plan. The US Family Health Plan (USFHP or the Plan) is a managed care program developed by the Department of Defense. As designated TRICARE Prime providers under a DoD contract, the Plan offers comprehensive health care benefits to members of the seven uniformed services, including active-duty family members, retirees and their family members, and survivors. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.** Reports to the Supervisor of Customer Service and under general supervision coordinates and manages the referral and/or authorization process in accordance with benefit contract guidelines and criteria. Ensures customer satisfaction by providing timely and accurate information when responding to customer inquireis, utilizing good judgment in triaging and documenting customer calls. Participates in the daily operations of the department which may include processing authorizations, participation in resolving claims related issues, assisting with internal and external mail, filing and other administrative duties assigned. * Requires knowledge of the referral and authorization process as well as the daily activities of an intake unit. * Requires an understanding of managed care * Basic Knowledge of ICD-9 diagnosis and CPT coding. * Requires knowledge of behavioral health and medical terminology. Level 1 - A minimum of a high school diploma or GED is required Level II Reports to the Supervisor of Customer Service and under general supervision coordinates and manages the referral and/or authorization process in accordance with benefit contract guidelines and criteria. Ensures customer satisfaction by providing timely and accurate information when responding to customer inquires, utilizing good judgment in triaging and documenting more complex customer calls. Participates in the daily operations of the department which may include processing authorizations, participation in resolving claims related issues, assisting with internal and external mail, filing and other administrative duties assigned. * Requires knowledge of the referral and authorization process as well as the daily activities of an intake unit. * Requires a comprehensive understanding of managed care * Comprehensive Knowledge of ICD-9 diagnosis and CPT coding. * Requires knowledge of behavioral health and medical terminology. Level 2 - A minimum of a high school diploma or GED is required. Certification in Customer Service preferred. Some college preferred. * Excellent interpersonal skills and demonstrated written and verbal communication skills necessary to interact with a diverse patient population, providers and staff. * Basic PC and software application skills. * Experience with data entry. * Basic administrative skills * Basic problem solving skills * Requires a basic understanding of managed care. Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.