Overview Medivest Customer Service Representatives play a vital role in ensuring that fiduciary accounts are administered in full compliance with the standards set forth by the Medicare Secondary Payer (MSP) Statute and applicable regulations. They are tasked with effectively communicating with members, healthcare providers, pharmacies, ancillary supply vendors, attorneys, and insurance companies, demonstrating expertise in MSP compliance. Representatives frequently answer inquiries and proactively reach out to these parties, performing a variety of tasks that require exceptional customer service, communication, and clerical skills. Essential Duties and Responsibilities Demonstrate, model and expect adherence to the company's core values and mission. Perform duties in a manner compliant with company policies. Stay informed about changes in industry regulations and company procedures. Communicate clearly and professionally with internal and external stakeholders via phone, video conferencing, and email. Maintain confidentiality and handle sensitive information with discretion and in accordance with HIPAA regulations. Provide exceptional service to clients, members, and colleagues. Address and resolve issues and concerns promptly, escalating complex cases to the appropriate department or manager when necessary. Accurately document all interactions and transactions, ensuring that records are complete, up-to-date, and compliant with company and regulatory requirements. Work collaboratively with team members and other departments to achieve organizational goals. Contribute to a positive team environment. Seek opportunities for professional development and skill enhancement. Participate in training sessions and stay updated on industry trends and best practices. Prioritize tasks effectively to meet deadlines and organizational objectives. Identify issues and propose solutions proactively. Take initiative to improve processes and enhance service delivery. Adapt to changing priorities, projects, and work environments. Embrace new challenges and changes with a positive attitude. Department Specific Responsibilities Demonstrate compassion, patience, and empathy when interacting with members. Answer inbound/outbound calls Address provider inquiries regarding eligibility and claim status. Review medication prior authorization requests. Oversee the coordination of benefits for members, ensuring seamless integration of various coverage sources. Provide members with clear and accurate information about their MSA benefits. Report account exhaustions and reactivations to CMS with precision. Ensure the first annuities are correctly directed to Medivest. Serve as a liaison between trust companies and medical providers, fostering strong communication. Notify CMS and members of account closures and exhaustions. Education and Experience Qualifications High School Diploma/GED Minimum of 5 years of experience in customer service, managing high call volumes with excellent phone skills and etiquette. Basic knowledge of workers' compensation and general liability insurance claims industry

• Preferred Basic knowledge of medical coding and/or medical claims processing
• Preferred Basic accounting concepts and best practices
• Preferred Basic CMS prescription formulary knowledge
• Preferred Skills & Abilities Requirements Independent decision making, negotiation, and problem-solving skills Ability to work in small teams on dynamic projects Strong analytical skills to assess service issues and develop effective solutions Excellent verbal and written communication skills, with the ability to explain complex regulatory concepts to both internal teams and clients Highly motivated and task-oriented, capable of managing a heavy workload, responding quickly to inquiries, and maintaining attention to detail Strong time management skills, able to maintain productivity and focus without distraction Quick learner with a high aptitude for and commitment to mastering industry-specific knowledge, particularly within the MSP sector Proficiency in the use of common office technology, including software such as Microsoft Office Suite, Microsoft 365, and Adobe Fluent in both Spanish and English, with outstanding oral and written communication skills in both languages.

Physical Requirements Ability to sit for extended periods while working at a computer workstation Extensive use of a computer, including keyboarding, mouse operation, use of a headset, and viewing a computer screen for long periods Ability to type accurately and efficiently for prolonged periods Work Environment Access to a stable and private internet connection and the ability to troubleshoot minor technical issues independently Access to a quiet and comfortable workspace that supports focus and productivity Ability to set up and maintain an ergonomic workspace to prevent strain or injury (including appropriate desk, chair, and computer equipment)

Job Type:

Full-time Pay:

$22.00

• $23.

04 per hour Expected hours: 40.0 per week

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance Application Question(s): Our hybrid work model requires employees to reliably commute to our Oviedo, FL office. Are you currently located within a reasonable commuting distance of the office and able to commute to Oviedo as required? The starting pay for this position is between $22.00 and $23.04 per hour, depending on qualifications and experience. Are you comfortable moving forward with this range?

Experience:

Customer service: 5 years (Required)

Language:

Spanish (Required)

Work Location:

Hybrid remote in Oviedo, FL 32765