Customer Service Representative
About this role
Start Date: Sept 14
Job Title: CSR/Data Entry - WFH
Job Type: Full Time
Pay : $14/hr
FLSA Status: Non-Exempt/Hourly
Grade: H2
Function/Department: Health Plan and Healthcare Services
Reporting to: Team Lead/Supervisor - Operations
Schedule: Monday-Friday 1.30pm-clean desk (end time depends on workload)
Key Responsibilities
Review incoming Grievance and Appeals documents for completeness, legibility, and relevance.
Accurately identify and assign the correct Line of Business (LOB) based on client and regulatory definitions.
Determine and classify the dispute type (e.g., grievance, appeal, expedited appeal, standard appeal) in accordance with client-specific guidelines.
Access multiple client systems and portals to retrieve, verify, and validate member information, including but not limited to: Member demographics Member ID numbers Plan and eligibility details Index documents by entering required data fields accurately into internal systems or client platforms.
Normalize and prepare documents when required to ensure all necessary information is available for downstream processing.
Adhere to all HIPAA, data privacy, and security requirements when handling protected health information (PHI).
Meet established productivity, accuracy, and quality standards.
Follow client-specific workflows, job aids, and standard operating procedures.
Identify discrepancies, missing information, or indexing issues and escalate according to established procedures.
Participate in quality audits, training updates, and process improvement initiatives as required.
Company at a glance
Firstsource Solutions Limited, an RP-Sanjiv Goenka Group company, is a global intelligence partner to enterprises across healthcare, banking and financial services, communications, media, technology, retail, and utilities.
We combine more than 25 years of domain expertise with an agent-first delivery model to design, build, and operate intelligent enterprise operations.
Our inch-wide, mile-deep practitioners work collaboratively to reimagine business process management. This is our Intelligence That Operates promise, powered by Kairos, the operating system that makes it real.
We unify consulting, implementation, and operations into a single full-stack engagement and underwrite outcomes, not effort, turning deep domain intelligence into a compounding operational advantage for the world's most regulated industries.
Our Firstsourcers are driven to Make It Happen for more than 200 leading global brands, including several Fortune 500 and FTSE 100 companies, across operations in the US, UK, India, Philippines, Mexico, Romania, Trinidad & Tobago, South Africa, and Australia.
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