Customer Service Representative (Remote)

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

Acentra Health is seeking a Customer Service Representative to join our growing and mission-driven team. This is an exciting opportunity to make a meaningful impact by serving as a key point of contact for our customers. In this role, you will handle incoming calls and assist customers by resolving questions, concerns, and service requests with professionalism and care. You will play an important role in delivering a positive customer experience while ensuring compliance with internal policies, procedures, and quality standards.

This is a full-time, fully remote role, with all essential home office equipment provided, including a company-issued laptop, monitors, keyboard, mouse, and headset. The position operates Monday through Friday from 12:00 p.m. to 9:00 p.m. EST, with rotating weekend coverage.

Responsibilities

• Maintain working knowledge of internal policies, procedures, and services.
• Utilize automated systems to log and retrieve information; perform accurate and timely data entry.
• Receive inquiries by telephone, email, fax, or mail and communicate responses within required turnaround times.
• Respond to telephone inquiries in a prompt, accurate, and courteous manner.
• Interact with external partners such as hospitals, physicians, beneficiaries, or other program recipients.
• Perform verification of healthcare services to facilitate payment for received services.
• Identify medical claims meeting CPT/DRG audit criteria and submit the necessary billing data.
• Serve as liaison between the internal and external partners.
• Investigate and resolve or report provider problems.
• Meet or exceed standards for call volume and service level per department guidelines.
• Initiate cases by collecting and entering demographic, provider, and procedure information into the system.
• Complete daily, monthly, and quarterly reports necessary for clinical team operations.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

• High school diploma or equivalent required.

• Minimum of 2 years of customer service and call center experience required

• Strong active listening and customer service communication skills, including verbal, written, and electronic communication, with the ability to communicate professionally and effectively

• Working knowledge of medical terminology.

• Familiarity with the health insurance industry or a healthcare environment.

• Completion of medical terminology coursework preferred.

• Detail-oriented with excellent organizational skills and the ability to prioritize tasks and meet established timelines

• Proficiency with computer-based software and tools, including Microsoft Office Suite (Word, Excel, Outlook, Teams).

• Bilingual Spanish/English proficiency is a plus.

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.

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.

~ The Acentra Health Talent Acquisition Team

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.

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 $17.50 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.

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