Clinical Operations Representative

Job Summary

Supporting daily operations for customer service, the full-time Clinical Operations Representative will assist doctor's offices and patients by processing requests via telephone, fax, and email while collaborating with Utilization Review Nurses to create medical cases in a remote environment.

Key responsibilities:

• Responds to customer inquiries regarding medical cases through phone and written correspondence
• Documents inquiry outcomes for accurate tracking and analysis while maintaining positive customer relations
• Handles complex calls and ensures timely updates to insurance data while adhering to HIPAA confidentiality guidelines

Required qualifications:

• Minimum of 2 years' experience in customer service or healthcare operations
• Associate's Degree in a business or health-related field preferred
• Strong problem-solving and troubleshooting skills with precise attention to detail
• Intermediate to advanced proficiency in Microsoft Word, Excel, and Outlook
• Phone queue experience and data entry skills preferred