Customer Service Specialist I

Handle large volume of calls and perform work in a timely manner. Attempts to collect full payment from patient or guarantor in a professional and courteous manner. Establishes payment arrangements per guidelines. Documents terms in billing system. Applies of payments collected over the phone to each date of service. Handles customer inquiries, disputes and complaints. Escalates contentious complaints to supervisor or higher management. Obtains all insurance, demographic, guarantor information and updates patient profile as well as bill third party payers as appropriate. Clearly documents in system summary of work and follow up steps after each call. Requirements High school graduate or GED certificate is required. A minimum of 6 months experience in a physician billing or third party payer environment. Must demonstrate an understanding of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations. Candidate must demonstrate the ability to understand and navigate the payer adjudication process. Patient financial and practice management system experience in Epic and/or other electronic billing systems is preferred. Knowledge of medical terminology is preferred. Previous call center/claims experience is preferred. Previous experience in an academic healthcare setting is preferred. Core Competencies Demonstrates expertise in patient billing processes, including understanding of insurance contracts, compliance regulations, and the payer adjudication process. Proficient in managing high call volumes while maintaining professionalism and accuracy in documentation. Highest-signal resume keywords Patient Billing Experience Understanding Of Insurance Benefits Payer Adjudication Process Epic Electronic Billing System Medical Terminology Knowledge ATS Optimization Keywords Hard Skills Billing Documentation Payment Arrangements Claims Processing Insurance Information Collection Dispute Resolution Soft Skills Professional Communication Customer Service Problem Solving Certifications & Qualifications High School Graduate GED Certificate Industry Keywords HMOs PPOs Medicare Medicaid Compliance Program Regulations Tools & Technologies Epic Electronic Billing Systems #J-18808-Ljbffr