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 need to be able to:Deliver an exceptional customer experience by responding to incoming calls from both in-network and out-of-network providers to assist with simple and complex inquiriesIn times of high call volumes, receive back-to-back calls with an “All Hands on Deck” approachAdhere to your assigned schedule - Monday-Friday, 8AM-5PM ESTProvide a quiet and distraction-free dedicated workspaceDuties & Responsibilities;Assist providers with claims and claims investigationsStatus InquiriesDenial RationaleAppealsResearch and RoutingExplanation of Payments / Explanation of Benefits RequestsAuthorizationsStatus InquiriesDenial RationaleUtilization Management AppealsPrior Authorization VerificationEligibility and BenefitsStatus InquiriesInterpreting Medical Benefit GridsVerification of Provider ParticipationCredentialing InquiriesDocumentationProvider Inquiries & Specific DetailsOutcome of the Call and Next Steps/ResolutionSelf-Service OptionsAssisting providers with education on available Self-Service OptionsWalk Providers through AvailityWhen you join us, you’ll enjoy;Competitive pay rate of $16/hourMedical, dental and vision benefitsPaid trainingGlobal Flexible Vacation Policy after trainingCompany-provided equipmentAdvancement opportunities – 80% of our frontline leaders have been promoted from withinMonthly rewards & recognition programsEmployee DiscountsEAP & Health and Wellness programs including a personal trainer dedicated to SutherlandWeekday schedule, Monday-Friday, 8AM-5PM ESTRequired QualificationsHigh School Diploma or equivalent1-2 years of experience working in a high-volume call center environment as a customer service representativeEffective verbal and written communication skillsStrong typing and analytical abilities40 Words-Per-Minute typing-speedActive listening and problem-solving abilitiesSoft skills and positive attitudeMulti-tasking skills with a strong attention to detailTime Management skillsSufficient Internet speeds while connected to a Remote Desktop Session (10MB Download / 2MB Upload)Preferred Qualifications1-2 years of experience in a medical office setting1-2 years of experience with healthcare insurance1-2 years of experience with billing or coding1-2 years of experience with back-end processingIMPORTANT 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 UsSutherland, 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 DocumentationDuring 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 allAdministrative 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.#SPEEOC and Veteran DocumentationDuring 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 allAdministrative 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.