Customer Service Representative

<span class="jobdescription"><p><strong>Start Date: ASAP</strong></p> <p>Job description:</p> <div> <div> <div> <div> <p><strong>Job Title: </strong>Data Entry</p> <p><strong>Job Type: </strong>Full Time</p> <p><strong>FLSA Status:</strong> Non-Exempt/Hourly</p> <p><strong>Grade:</strong> H2</p> <p><strong>Function/Department: </strong>Health Plan and Healthcare Services</p> <p><strong>Reporting to: </strong>Team Lead/Supervisor - Operations</p> <p><strong>Pay : </strong>$14</p> <p><strong>Key Responsibilities</strong> </p> <p>Review incoming Grievance and Appeals documents for completeness, legibility, and relevance.</p> <p>Accurately identify and assign the correct Line of Business (LOB) based on client and regulatory definitions.</p> <p>Determine and classify the dispute type (e.g., grievance, appeal, expedited appeal, standard appeal) in accordance with client-specific guidelines.</p> <p>Access multiple client systems and portals to retrieve, verify, and validate member information, including but not limited to:  Member demographics Member ID numbers Plan and eligibility details Index documents by entering required data fields accurately into internal systems or client platforms.</p> <p>Normalize and prepare documents when required to ensure all necessary information is available for downstream processing.</p> <p>Adhere to all HIPAA, data privacy, and security requirements when handling protected health information (PHI).</p> <p>Meet established productivity, accuracy, and quality standards.</p> <p>Follow client-specific workflows, job aids, and standard operating procedures.</p> <p>Identify discrepancies, missing information, or indexing issues and escalate according to established procedures.</p> <p>Participate in quality audits, training updates, and process improvement initiatives as required. </p> <p> </p> </div> </div> </div> </div> </span>