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Customer Complaint Specialist
| Company: | Quality Health Strategies Company Profile | Current Opportunities (13) |
| Job Location(s): | Easton, Md |
| Employment Term: | Regular |
| Employment Type | Full Time |
| Hours per Week: | 40 |
| Start Date: | ASAP |
| Starting Salary Range: | Not Provided |
| Required Education: | High School or Equivalent |
| Required Experience: | 2 to 4 years |
| Related Categories: | Customer Service - General, Customer Service - Call Center |
Position Description
Health Integrity, LLC is a wholly owned subsidiary of Quality Health Strategies. Health Integrity was awarded the Medicare Prescription Drug Integrity Contract (MEDIC) for the Centers for Medicare and Medicaid Services (CMS) and is the contractor responsible for performing benefit integrity tasks for CMS related to the new Medicare Part D Prescription Drug program. We currently have an opening for a Customer Complaint Specialist.
The Customer Complaint Specialist (CCS) supports MEDIC by taking live calls from beneficiaries concerning potential fraud, waste, or abuse in the Medicare Prescription Drug Program. The Customer Complaint Specialist uses decision-making skills to decide the disposition of a call, determining if the complaints will be forwarded to 1800-MEDICARE or CMS regional office, if complaints will be referred immediately to Benefit Integrity, or if the case requires further investigation and the gathering ofadditional information.
The CCS will research topics related to Medicare guidelines and policy, including web sites and e-media and support the MEDIC Claims Analysts in their fraud investigation. The CCS reviews information on individual complaints and determines if services were rendered and correct co-payments and deductibles were applied. Activities support the successful implementation and completion of Medicare Prescription Drug Integrity reviews in various delivery settings.
Health Integrity is a highly successful and rapidly growing not-for-profit company with a passion for excellence.
We offer you:
Excellent company paid benefits, including parking;
Flexible weekday hours with holidays off;
Interesting and challenging work;
A stimulating work environment; and
The chance to join a team in making a positive difference.
To Apply
Affirming equal opportunity in principle and practice, Health Integrity is an equal opportunity employer, committed to developing a diverse workforce
The Customer Complaint Specialist (CCS) supports MEDIC by taking live calls from beneficiaries concerning potential fraud, waste, or abuse in the Medicare Prescription Drug Program. The Customer Complaint Specialist uses decision-making skills to decide the disposition of a call, determining if the complaints will be forwarded to 1800-MEDICARE or CMS regional office, if complaints will be referred immediately to Benefit Integrity, or if the case requires further investigation and the gathering ofadditional information.
The CCS will research topics related to Medicare guidelines and policy, including web sites and e-media and support the MEDIC Claims Analysts in their fraud investigation. The CCS reviews information on individual complaints and determines if services were rendered and correct co-payments and deductibles were applied. Activities support the successful implementation and completion of Medicare Prescription Drug Integrity reviews in various delivery settings.
Health Integrity is a highly successful and rapidly growing not-for-profit company with a passion for excellence.
We offer you:
Excellent company paid benefits, including parking;
Flexible weekday hours with holidays off;
Interesting and challenging work;
A stimulating work environment; and
The chance to join a team in making a positive difference.
To Apply
Affirming equal opportunity in principle and practice, Health Integrity is an equal opportunity employer, committed to developing a diverse workforce
Contact Information
For immediate consideration, please provide your resume and salary requirements by visiting http://www.healthintegrity.org/ and applying to position .
