Customer Service Representative

This is an exciting opportunity to join a rapidly growing company!

PRIA Healthcare works with the most progressive companies in the MedTech industry, we build comprehensive patient access solutions that accelerate the commercialization and rapid adoption of truly innovative procedures. We are currently looking for a Customer Service Representative that is ready to join our team of skilled and dedicated individuals supporting the mission of patient access to care and customer service.

In this role, you will be providing support to various Patient Access programs. Our Patient Access Programs are designed to be dedicated to a specific Medical Device Manufacturer with a new and innovative medical device, considered to be Experimental/Investigational and provide day to day support of Prior Authorizations and Appeals for those specific Category 3 CPT codes. Our goal is to drive product/program utilization by submitting patient-based appeals of denied authorizations. By driving utilization and demonstrating demand we are working to create positive insurance coverage for the new product. Experience working with insurance authorizations and appeals and knowledge of medical reimbursement policies within a healthcare organization are preferred. 

In addition to a well-rounded benefits package, Paid Time Off, Medical/Dental/Vision and 401(k), we also offer our employees training opportunities including tuition reimbursement, career development courses and employee referral programs.

But wait, there’s more… culture is what unites us. We are proud of the environment we have built that defines our culture and focuses on keeping our employees engaged, healthy, happy and motivated. We have committees that meet regularly to develop creative ideas to plan fun activities, volunteer workdays and to promote wellness. 

PRIA Healthcare was recognized as one of the Best Places to Work in Connecticut in 2020!

Job Responsibilities:

• Deliver exceptional customer service as a means to build loyalty, improve retention, and satisfy service goals and objectives
• Resolve customer inquiries and problems through effective interaction
• Direct/transfer incoming calls from providers, sales reps, clinical contacts, and clients to the correct program phone line
• Utilize appropriate resource materials to efficiently and effectively interpret, respond, and resolve customer inquiries/problems.
• Knowledge of program offerings and hours of operations
• Strong interpersonal skills in order to handle difficult calls in a professional manner
• Document calls in accordance with company policies
• Work with peers to solve problems and promote teamwork
• Escalate difficult calls, as needed, to the correct internal constituents
• Comply with company HIPAA laws and other policies and procedures

Required Skills:

• Ability to create a positive and fun team environment
• Must demonstrate excellent communication skills, verbal and written
• Strong organizational skills with the ability to prioritize calls by level of importance
• Ability to make reasonable decisions based on established company standards and guidelines
• Ability to work in a fast-paced team environment
• Experience working with insurance claims, appeals, prior authorization and billing/coding (preferred)
• High school diploma or equivalent preferred but will substitute for applicable work experience
• Experience with Medicare, Medicaid, Tricare, Workers Compensation and Commercial Insurance

Benefits:

PRIA Healthcare Management offers a competitive package of benefits including but not limited to Medical/Dental Insurance, 401K, Access to Long Term and Short-Term Disability, Paid Time Off and Paid Holidays.

This position will work out of our main office located in Torrington, CT. It is not a remote position.