HCS Customer Service Specialist II (SCA)

Position Overview Expected Hiring Range: $19.00 per hour. As a Healthcare Customer Service Specialist II (SCA), you will work within a team and be the primary point of contact for all providers, Medicare contractors, and related stakeholders. This role involves professional, accurate, and timely responses to CMS (Medicare) and provider inquiries via written, telephonic, and electronic communication. Key Responsibilities Maintain current knowledge of all contract requirements and objectives. Develop professional working relationships with colleagues, healthcare providers, and other Medicare contractors. Take inbound calls from providers to answer questions and resolve complex issues. Make outbound calls to healthcare providers as a courtesy to confirm receipt of letters requesting records for review. Respond to assigned written communications from providers in a timely and accurate manner. Educate providers on proper process protocols and their appeal rights. Establish appropriate contacts and perform necessary research to validate provider contact information. Conduct critical due‑diligence follow‑ups if additional research or action is required to resolve an inquiry. Enter and update all contact and activity information into tracking logs and the audit platform when not automatically completed by the system (e.g., telephone calls, correspondence responses, special notes). Research and route internal/external communications to the appropriate person or department. Notify management of escalated concerns related to the audit program, legal action, government intervention, or other audit issues, and provide suggestions to improve or correct processes or documents. Perform miscellaneous duties as assigned in a highly professional manner. Knowledge, Skills, and Abilities Needed Excellent verbal and written communication skills. Skilled in data entry and computer proficiency. Working knowledge of Excel. Courteous, professional, and respectful attitude. Strong understanding of customer service policies and processes. Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program. Healthcare and insurance terminology knowledge preferred but not required. Flexibility to prioritize and handle non‑standard situations that may arise. Must be detailed, organized, and able to manage various job duties as required. Maintain a strong work ethic and attendance. Required and Preferred Qualifications At least two (2) years’ experience in a call center or customer service position (required). At least one (1) year of claims processing/billing experience (preferred). High School diploma or GED (required). Must maintain HIPAA Certification (required). Benefits Medical, dental, and vision coverage. HSA/FSA options. Life insurance coverage. 401(k) savings plans. Family/parental leave. Paid holidays and paid time off annually. Equal Opportunity Employer Statement Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. #J-18808-Ljbffr