Do you enjoy helping others, answering questions and resolving problems? Do you have any experience in the healthcare/medical field or are you interested in pursuing a career in the field? Are you looking for an opportunity to build a fulfilling career while working from home ?

Join Us.

We're Sutherland, and we are seeking attentive, goal-oriented individuals to support the expanding needs of one of our largest health insurance company customers. In this role, you will be responsible for the following:

Delivering an exceptional customer experience by responding to incoming calls from both in-network and out-of-network providers to assist with simple and complex inquiries

In times of high call volumes, phone calls may be received back-to-back with an “All Hands on Deck” approach

Duties Responsibilities;

Assist providers with claims and claims investigations

Status Inquiries

Denial Rationale

Appeals

Research and Routing

Explanation of Payments / Explanation of Benefits Requests

Authorizations

Status Inquiries

Denial Rationale

Utilization Management Appeals

Prior Authorization Verification

Eligibility and Benefits

Status Inquiries

Interpreting Medical Benefit Grids

Verification of Provider Participation

Credentialing Inquiries

Documentation

Provider Inquiries Specific Details

Information provided on the phone call

Routing Pathways

Self-Service Options

Assisting providers with education on available Self-Service Options

When you join us, you’ll enjoy;

Competitive pay rate of $16/hour

Medical, dental and vision benefits

Paid training

Global Flexible Vacation Policy after training

Company-provided equipment

Advancement opportunities – 80% of our frontline leaders have been promoted from within

Monthly rewards recognition programs

Employee Discounts

EAP Health and Wellness programs including a personal trainer dedicated to Sutherland

Weekday schedule, Monday-Friday, 8AM-5PM EST

Required Qualifications

High School Diploma or equivalent

1-2 years of experience working in a high-volume call center environment as a customer service representative

Effective verbal and written communication skills

Strong typing and analytical abilities

40 Words-Per-Minute typing-speed

Active listening and problem-solving abilities

Soft skills and positive attitude

Multi-tasking skills with a strong attention to detail

Time Management skills

Sufficient Internet speeds while connected to a Remote Desktop Session (10MB Download / 2MB Upload)

Quiet and distraction-free dedicated workspace

Schedule adherence – Be present and on-time

Preferred Qualifications

1-2 years of experience in a medical office setting

1-2 years of experience with healthcare insurance

Medicaid experience highly favored

1-2 years of experience with billing or coding

1-2 years of experience with back-end processing

IMPORTANT NOTE : This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.

About Us

Sutherland, recently recognized as a Great Place to Work in the US, is a digital transformation company, making digital processes feel more human for the customers that we serve. We have been helping customers globally, across industries from financial services to healthcare, entertainment to retail, insurance to gaming, and everything in between, provide exceptional experiences for their customers for over 35 years.

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.