Lead Call Center Representative - SCA

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 mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. 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.

Job Summary:

This Lead Call Center Representative responds to customer inquiries via phone, email, or other channels. Provides information, resolves issues, and escalates complex cases, while also documenting interactions and maintaining account accuracy. This role requires strong communication, problem-solving, and computer skills. Responsibilities include intaking documentation into the appropriate systems. Overall expectations are to provide outstanding service to internal and external customers and strive to resolve the members and provider inquires by analyzing and resolving complex issues which were not resolved by the call center representative. Performance expectations are to meet or exceed operations production and quality standards.

**This position is remote, but candidates must reside within driving distance of El Paso, TX or Tallahassee, FL as needs could change from remote to on-site in the future.

Responsibilities:

• Available to work scheduled work hours based on operational needs. A shift will be assigned to you between the hours of 8:00am-8:00pm Monday through Friday
• Contact customers to respond to complex inquiries or to notify them of claim investigation results and any planned adjustments
• Assist with escalated calls when needed
• Provide support to call center agents while on calls to resolve issues and questions which may arise
• Investigate and resolve or escalate unresolved customer grievances, appeal, and claim resolution to designated departments for further investigation
• Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
• Under general supervision research and articulately communicate information regarding member eligibility, benefits, services, claim status, and authorization inquiries to callers while maintaining confidentiality
• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal)
• Under general supervision, perform necessary follow-up tasks to ensure member or provider needs are completely met
• Support team members and participate in team activities to help build a high-performance team.
• Thoroughly documents customers' comments/information and forwards required information to the appropriate staff
• Determine and report knowledge gaps based on questions, escalated calls and escalated tickets to leadership for coaching and training
• Read, understand, and adhere to all corporate policies including policies related to HIPAA

Required Qualifications

• High School Diploma or GED equivalent
• Previous experience with computer applications, such as Microsoft Word and PowerPoint
• 2+ years of call center experience
• Must live within driving distance from El Paso, TX or Tallahassee, FL

Preferred Qualifications

• Verbal and written communication skills, attention to detail, customer service skills and interpersonal skills
• Ability to work independently and manage one's time

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 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

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.

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

Visit us at https://careers.acentra.com/jobs

EEO 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay for this position is listed below.

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

#LI-AF1