Lincoln (Notice and Proof)- Kingsland

Company Description

Sutherland is seeking a motivated and passionate person to join us as a Customer Service Consultant. We are a group of driven and hard-working individuals. If you are looking to build a fulfilling career and are confident you have the skills and experience to help us succeed, we want to work with you!

Job Description

Key Responsibilities 
Review and process incoming Notice and Proof forms in accordance with company policies, guidelines, and regulatory requirements. 
Accurately enter medical provider information into claims processing systems. 
Identify discrepancies or missing information and follow up with providers, employers, or claimants as needed. 
Ensure timely adjudication of follow-ups to maintain productivity and quality expectations. 
·       Prepare, review, and accurately complete written letters for medical providers and claimants in accordance with policy and regulatory requirements. 
  
Collaborate with internal teams such as Quality Assurance, Customer Support, and Medical Review units to resolve complex cases. 
Escalate high risk or unusual forms or follow ups to leadership or medical reviewers as appropriate. 

Qualifications

• Minimum four CXC subjects including English Language.
• Minimum of 1-year direct customer interaction via phone and email preferred.
• Works well in a metric driven environment
• Ability to think critically and interpret eligibility requirements based on guidelines and rules, qualifiers, defined limits, etc.
• Understand exception scenarios and drive timely closures/resolution.
• Excellent customer service skills; exhibiting empathy while adhering to business guidelines
• Strong basic math skills
• Strong attention to detail and good interpersonal skills
• Strong decision making and problem-solving skills
• Able to work independently with less supervision to complete assigned work tasks within established time frame
• Proficient with Microsoft applications (word, outlook, etc)
• Application of phone and email etiquettes in customer interactions
• Strong listening, understanding, and receptive skills to ensure positive customer experience for claimants/employees
• Ability to draft and exchange communication with right messaging compliant with state regulations and customer procedures
• Strong research and factfinder to be able to articulate claim ineligibility with reasoning clearly
• Ability to multi-task, with a demonstrated ability to work in a fast-paced environment handling a large volume of caseload
• Must be willing to do a background check

Additional Information

All your information will be kept confidential according to EEO guidelines.

As your prospective employer, we need to process your Personal Data as needed to evaluate your qualification for the position you are applying for with Sutherland.  During the recruitment process, your Personal Data may be transferred outside of Jamaica and disclosed to third parties in the normal course of the recruitment and/or employment process or as needed to comply with applicable laws. This may include transferring information to our affiliated Companies for purposes connected to your employment with the company or to the management of Sutherland’s business.