Disability Customer Service Representative

The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup.

The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.

MAJOR DUTIES & RESPONSIBILITIES Handling Receipt of New Cases: Intake new cases and review/verify information and requests.

Draft cases by entering information into the Dane Street system, AccessDS.

Work with the client on any information missing pertinent to processing the claim.

Sort, organize and create a medical document listing - if required by the client, and in line with specific special handling.

Oversight of Cases: Monitor, process and track cases to ensure we meet deadlines.

Assignment of Cases: Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements and other client requirements.

Ensure that the assigned physician has no conflict of interest with the case assignments Client Interaction: Update clients frequently on cases in progress.

May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer.

Ensure proper documentation for specified cases is provided to the client.

Requirements COMMUNICATION: Indicate applicable type of communication ✓ External ✓ Internal EDUCATION/CREDENTIALS: An Associate’s Degree preferred.

JOB RELEVANT EXPERIENCE: Business experience in a healthcare and/or insurance setting is preferred.

JOB RELATED SKILLS/COMPETENCIES: Good communication skills with a clear understanding of company business lines.