Healthcare Customer Service Representative (NC)

Job Description

Job Description

Description:

RevCycle is growing, and we’re excited to welcome new team members! With over 30 years in business, we focus on developing our employees and helping them reach their full potential. Work from home or from our Marshfield, WI office.

Our next training class is expected to start in early 2027. Apply now to be among the first candidates considered!  

EPIC experience is preferred but not required.

Position Summary:

• Delivers exceptional and consistent customer experiences by demonstrating excellence in understanding and resolving requests with patience, empathy, compassion, and sincerity. Handles customer inquiries through inbound and outbound calls as well as written communication.
• This position exists to effectively manage inquiries and concerns related to billing and insurance with the goal of offering payment options and facilitating the processing of payments. Customer Service Representatives will work in a company office or home office environment. They will operate with minimal management guidance to exceed Key Performance Indicators (number of calls handled/hr., successful payment resolution, and call quality). This role is expected to follow company and client policies, procedures, and applicable laws.

Essential Duties and Responsibilities:

• Take calls from patients, law offices, insurance companies, and other outside facilities to resolve complex billing and insurance issues
• Make outbound calls and take inbound calls from patients to resolve balances on accounts with a status that may be aging but has not been sent for collections
• Answers complex billing and insurance questions (i.e. deductibles, co-insurance, co-pays, complex denials and charge disputes, claim resubmissions, eligibility issues, and coding disputes)
• Reviews financial information and recommends payment options and/or assistance programs in accordance with client guidelines
• Manages both common and challenging objections and concerns from consumers
• Discusses and helps consumer think through payment resources and makes necessary referrals to the client
• Uses required scripts/verbatims, skillfully navigating guidelines to maximize potential recovery on each call
• Maintains working understanding of account requirements, leveraging related documentation and resources as needed
• Independently and efficiently performs account documentation including notes and codes, making few errors, requiring minimal assistance
• Skillfully works within both internal and client systems
• Adheres to company Core Values and Strategic Anchors
• May learn and perform other duties and responsibilities as assigned based on business needs

Required Knowledge, Skills and Abilities:

• Prior work experience in a call center and healthcare customer service setting is preferred
• Familiarity with Artiva and Cerner Soarian application is preferred. EPIC is a plus.
• Working knowledge of medical billing and coding is preferred
• Prior work experience in a medical office and/or general understanding of health insurance is preferred
• Able to communicate clearly, both verbally and in writing, and utilize proper grammar and telephone etiquette and provided electronic tools
• Able to navigate multiple computer applications and databases
• Moderate to advanced computer keyboard typing and navigation skill
• Able to communicate on the phone and navigate multiple computer systems simultaneously
• Able to overcome patient objections and obstacles to negotiate payment successfully
• Reliable and responsible. Arrives on time and uses time productively and efficiently
• Manages self effectively in a work from home environment, remaining focused on work and delivering required outcomes
• Possesses and demonstrates professional judgement and operates with client business acumen.
• Understands sensitive personal information (SPI) and sensitive consumer information (i.e., Protected Health Information (PHI)) and maintains confidentiality of this information
• Able to use tools provided to compute basic math calculations using addition, subtraction, multiplication, division, and percentages
• Self-motivation and committed to career success
• High School Diploma or equivalent (i.e., GED) required
• Prior supervisory experience is welcome in this growing company

Work Environment:

Employee works in a company office and/or home office and sits at a desk during regularly scheduled work hours. Employee will work with an online team utilizing screen monitoring and/or video conferencing. Employee answers and makes telephone calls using a computerized telephone; types on a standard keyboard; reads and comprehends information from a computer terminal and/or written resources. Employee may occasionally be required to stand or walk short distances along with bend or twist to access lower and higher desk drawers.

Career Path Note: The Customer Service Representative is a fully trained production role in the organization. They are relied upon in all cases to meet and in most cases exceed stated KPIs, goals and objectives. Those who desire may find advancement as a team lead, or in a functional role. These opportunities have unique requirements which are detailed in the respective job descriptions. Employees are also encouraged to work with their department leadership, Human Resources and/or company leadership to discuss and work toward their career goals.

Disclaimer: This job description provides a summary of essential job functions and required knowledge, skills, abilities, education, and experience. It may be modified at any time depending on the organization's needs. Management reserves the right to assign or reassign duties and responsibilities to this job at any time. The existence of this job description does not guarantee employment. It is understood that employment is “at will.”