Customer Services Representative

Customer Service Representative

Join our team as a Customer Service Representative, where you'll play a key role in supporting patients and providers by resolving billing issues, handling inquiries, and ensuring client satisfaction. You'll take approximately 45-55 inbound calls per day, onsite and will have a set schedule Monday-Friday between the hours of 7am-5:30pm. If you have experience in high-volume contact centers, possess strong de-escalation skills, and enjoy helping people, we'd love to meet you! Being bilingual (Spanish/English) and having medical/healthcare/insurance experience are big pluses as well. Join us and be part of a supportive team that values great service and a positive attitude. You belong here!

POSITION SUMMARY Provides Customer Service functions dealing directly with patient inquiries and complaints as well as issues as reported via phone or customer service calls and correspondence. Oversees collection of timely documentation from network providers and patients to ensure adherence to quality standards and timely filing requirements

CORE FUNCTIONS 1. Receives incoming phone calls from patients and providers in reference to payment issues, perceived inappropriate patient service and updates on insurance data.

2. Responsible for determining nature of call and documenting via claim system an appropriate associated reason code.

3. Effectively research, resolve and respond to billing issues accurately and expeditiously.

4. Supplies support function to Reimbursement area in posting zero payment Explanation of Payments from Insurance companies.

5. Monitor patient accounts providing account reconciliation to facilitate prompt payment and prevent inappropriate transfers to the outside collection agency.

6. Responsible for cross-functional assistance with EOB Adjustments, Bad Debt Recovery Trailer Entry and Cash Payment mailing.

KNOWLEDGE, SKILLS AND ABILITIES

• Requires the ability to communicate clearly and concisely.
• Mathematical skills resulting from external and internal sources, verbal and written communication skill, capability to prioritize completing multiple projects.

MINIMUM QUALIFICATIONS

• Requires a high school diploma or GED; with a minimum of two years of customer service experience.
• Requires excellent verbal and organizational skills, the ability to interface with difficult customers and work with minimum direct supervision to meet required goals.

PREFERRED QUALIFICATIONS

• One year of previous medical billing experience.
• Additional related education and/or experience.

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Our organization supports a drug-free work environment.

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