Physician HealthCare Network

We build comprehensive patient access solutions that accelerate the commercialization and rapid adoption of truly innovative procedures. We are currently looking for a Customer Service Representative that is ready to join our team of skilled and dedicated individuals supporting the mission of patient access to care and customer service.

In this role, you will be providing support to various Patient Access programs. Our Patient Access Programs are designed to be dedicated to a specific Medical Device Manufacturer with a new and innovative medical device, considered to be Experimental/Investigational, and provide day-to-day support of Prior Authorizations and Appeals for those specific Category 3 CPT codes. Our goal is to drive product/program utilization by submitting patient-based appeals of denied authorizations. By driving utilization and demonstrating demand we are working to create positive insurance coverage for the new product. Experience working with insurance authorizations and appeals and knowledge of medical reimbursement policies within a healthcare organization is preferred.
In addition to a well-rounded benefits package, Paid Time Off, Medical/Dental/Vision, and 401(k), we also offer our employees training opportunities including tuition reimbursement, career development courses, and employee referral programs.

P Healthcare was recognized as one of the Best Places to Work in Connecticut in 2020!

Job Responsibilities:

Deliver exceptional customer service as a means to build loyalty, improve retention, and satisfy service goals and objectives
Resolve customer inquiries and problems through effective interaction
Direct/transfer incoming calls from providers, sales reps, clinical contacts, and clients to the correct program phone line
Utilize appropriate resource materials to efficiently and effectively interpret, respond, and resolve customer inquiries/problems.
Knowledge of program offerings and hours of operations
Strong interpersonal skills to handle difficult calls in a professional manner
Document calls by company policies

Required Skills:

Ability to create a positive and fun team environment
Must demonstrate excellent communication skills, verbal and written
Strong organizational skills with the ability to prioritize calls by level of importance
Ability to make reasonable decisions based on established company standards and guidelines
Ability to work in a fast-paced team environment

Experience working with insurance claims, appeals, prior authorization and billing/coding (preferred)
High school diploma or equivalent preferred but will substitute for applicable work experience