Customer Service Representative II

The Puyenpa family of companies are comprised of multiple SBA Certified Native American Tribal 8(a) and multi-certified organizations focused on delivering Information Technology, Management Consulting, and General Construction solutions to the Federal Government along with the Commercial Sector. We are seeking a Customer Service Representative II to support The Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) program.

This position courteously and professionally contacts and communicates with providers to obtain required medical record documentation as early as possible. The CSR works in a fast-paced challenging environment using clear, concise descriptions of the requested provider documentation to avoid misunderstanding and the need for repeated follow-up calls.
Candidates with prior CERT experience preferred. Prefer bilingual (Spanish speaking) candidates. This is a remote role, candidates should ideally reside in . Dallas County, TX; Anne Arundel County, MD; Henrico County, VA; Montgomery County, AK; Chesterfield County, VA; Prince William County, VA; Cumberland County, NJ. areas.

The main responsibilities of the role include:

• Requests for records and information from providers.
• Responds to telephone inquiries promptly, professionally, and efficiently to provide resolution.
• Analyzes provider questions to determine best use of resources to resolve the situation.
• Serves as liaison between the providers and the various departments or team members in response to inquiries.
• Professionally responds to all written inquiries (letter, fax, e-mail).
• Processes rejected records that do not meet initial inspection criteria and contacts Providers to resubmit legible copies.
• Assist the providers in identifying what is being requested and answers their queries.
• Provides records to the Medical Records Clerks for MRS assignment.
• Assists with Medical Record Clerk workload as needed.
• Maintains competency and attends required education and training programs.
• Complies with all departmental protocols, policies and procedures.
• Performs other duties as assigned by Medical Records Manager.

Skills, Knowledge, Abilities:

• Proficiency with computers and computer software, specifically MS Word and MS Excel
• Ability to work within a call center environment and handle multiple phone lines throughout the business day; minimum six months of customer service experience with Call Center detail.
• Ability to be able to speak clearly and articulate in a professional manner.
• Maintains a neat, organized work area.
• Ability to work with others in a team environment.
• Familiarity with department equipment (computers, copiers, fax machines, scanners).
• Ability to perform record imaging after training.
• Ability to perform record filing and retrieval.
• Knowledge of medical record processing and procedures.
• Knowledge of medical terminology.
• Knowledge of healthcare and Medicare forms, documentation, and facilities.

Education:

• Associate’s degree in any of the following disciplines:
  • Medical Records
  • Marketing/Business/Sales
  • Criminal Justice
  • Computer Science
• Or high school diploma or a G.E.D and two years of customer service, call center and/or medical record experience and/or criminal justice/troubleshooting experience

Puyenpa provides a variety of benefits including company-paid health, dental & vision insurance coverage, as well as additional employee-paid health insurance options; company-paid life and disability insurance; 401k retirement savings plan with employer match; 11 company paid holidays per year, and paid time off.

Puyenpa is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable federal, state, or local law. Puyenpa complies with applicable federal contractor requirements regarding protected veterans and individuals with disabilities. Puyenpa provides reasonable accommodations to qualified individuals with disabilities during the application process. To request an accommodation, please contact [email protected].

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