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Customer Service Agent in Greenwich, CT at Pride Health

Date Posted: 5/10/2019

Job Snapshot

  • Employee Type:
  • Location:
    Greenwich, CT
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Customer Service Representative for a health plan

Provide service to providers, pharmacies and patients.

Prepare and process a high volume of requests for authorization of service received through fax, phone and online portals. Complete tasks within the Authorization Tracking System (ATS). Verify eligibility/benefits, documenting information required to process an authorization such as services/prescriptions requested, provider notes and medical history.  Follow-up to obtain missing information. 
Perform outgoing telephone contact with providers, provider office staff, pharmacies and patients. Work with external customers in a professional and effective manner using telephone scripts, information form ATS and general experience to complete tasks and resolve issues.   
Receive a high volume of inbound calls from providers, provider office staff, pharmacies and patients.  Maintain and use a current working knowledge of company policies, procedures, systems, contractual obligations, infertility, business and related terminology, and phone system protocol to provide superior service to clients. 
Prepare prescription requests and forward approved prescriptions to pharmacy for processing. 
Record and appropriately communicate problems and suggest improvement to systems, scripts, processes and reports.  
Follows HIPAA protocol when discussing or accessing protected health information.  


Previous Customer Service experience in a Call Center environment required.

Prior Customer Service experience in the healthcare or health insurance industry desirable.

Experience using MS Office product including Word and Excel.

Medical terminology, CPT, and ICD-9/ICD-10 coding experience extremely desirable.

HIPAA experience useful. 

Hours are Monday-Friday 11am-7:30pm.