Customer Service Representative - Full Time (Hyrbrid South Portland Maine)

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.

Acentra Health is looking for a Customer Service Representative to join our growing team.

Job Summary

• As a Customer Service Representative, you will be at the forefront of delivering exceptional service, serving as the first point of contact for our valued customers. In this instrumental role, you will handle incoming calls with professionalism and care, resolving customer inquiries, addressing complaints, and fulfilling requests. Your ability to provide effective solutions while adhering to our internal policies and procedures will make a lasting impact on customer satisfaction and our organization's success. If you thrive in this type of environment and enjoy helping others, this is the perfect opportunity for you!

Responsibilities

• Develop and maintain working knowledge of internal policies, procedures, and available services to provide accurate information and assistance.
• Utilize automated systems to log, retrieve, and update information while ensuring precise and timely data entry.
• Handle inquiries received via phone, email, fax, or mail, providing accurate responses within required turnaround times.
• Respond to telephone inquiries promptly, professionally, and with a customer-focused approach.
• Engage with external partners, including hospitals, physicians, beneficiaries, and program recipients, to provide necessary support and information.
• Verify healthcare services to ensure eligibility and facilitate payment processing.
• Identify medical claims that meet CPT/DRG audit criteria and submit the required billing information for processing.
• Act as a liaison between internal teams and external partners to ensure seamless communication and resolution of inquiries.
• Investigate, troubleshoot, and escalate provider issues as needed to facilitate timely resolution.
• Consistently meet or exceed departmental performance standards for call volume and service quality.
• Accurately initiate and document cases by entering demographic, provider, and procedure details into the system.
• Prepare and submit daily, monthly, and quarterly reports essential for supporting clinical team operations.

• High school diploma or equivalent required.
• Minimum of two years of customer service experience, preferably in a healthcare or call center environment.
• Completion of medical terminology coursework is preferred.

• Strong understanding of medical terminology.
• Familiarity with the health insurance industry, including policies and claims processes.
• Excellent verbal communication and active listening skills to provide exceptional customer service.
• Bilingual proficiency in Spanish and English 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 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.

Compensation

The pay range for this position is $16.50 - $18.50 per hour

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.

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 Acentra.com/careers/

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