Offshore CSR
Core
Manage retrieval of APS and medical records for US insurance clients via phone and email, ensuring accurate documentation and timely resolutions.
Role type
Customer Service Representative (APS Retrieval)
Builds
Accurate medical record retrieval and client notifications
Domain
Healthcare administration / Insurance
Deliverable
client delivery
Required skills
Outbound calling, email communication, case investigation, data verification, HIPAA compliance, duplicate case management, authorization review
Preferred skills
US healthcare experience, APS retrieval experience, medical records experience
Technologies
Multiple tools and dashboards
Responsibilities
Make outbound calls to medical providers to clarify requirements and speed up record retrieval; Send email follow-ups to providers and facilities on pending requests; Handle client escalations and provide timely resolutions; Review NYL cases and document reasons for escalation; Send client notifications for Banner cases; Email clients for approval regarding provider fees; Notify clients when records will not be released; Review and close duplicate or overtime cases; Manually correct authorizations exceeding system limits; Remove unwanted authorizations and documents from case files; Add special instructions to cases missing them; Follow HIPAA and data privacy guidelines; Manually verify records and communications before taking action; Meet daily productivity targets and quality audit standards; Coordinate with the onshore team on process updates.