Customer Service Representative

We are offering a long term contract employment opportunity for a Customer Service Representative. This role is remote and primarily functions within Pacific Time Zones.

Responsibilities:

• Accurately process patient data, including appointments, authorizations, claims, invoices, eligibility benefits, and appeals
• Provide exceptional customer service, demonstrating care and concern for every internal and external customer
• Maintain the performance goals established for the position, focusing on patient satisfaction, accuracy, quality, and consistent attendance
• Utilize double monitors for data entry and resource use, ensuring adherence to guidelines
• Assist other Patient Support Center Representatives and Supervisors with daily paperwork load to resolve and/or document patient issues
• Recognize financial, medical, and legal risks based on data collected during customer interactions and follow appropriate procedures
• Translate oral information into concise and accurate written documentation per guidelines
• Act as a patient advocate, providing services to internal and external customers involving the exchange of complex and sensitive information
• Assist new or potential members in the choice of Primary Care Physician (PCP) and supply general information about the medical group
• Page clinicians and assist Telehealth Nurses as necessary.
• Proficiency in Customer Service is mandatory, as this role demands extensive interaction with patients and other healthcare professionals.
• Experience in Data Entry is necessary for maintaining patient records and other pertinent information.
• Ability to handle Documentation professionally, ensuring accuracy and privacy.
• Prior experience in Training staff on new procedures and policies is a plus.
• Familiarity with healthcare Procedures and Policy, ideally within the NHS.
• Capable of efficiently Schedule Appointments for patients and healthcare professionals.
• Comfortable with handling Invoice processing and related tasks.
• Committed to maintaining Quality in all aspects of the job.
• Knowledge of About Time software for efficient time management is preferable.
• Strong Internet skills to aid in research and communication.
• Understanding of Medical Coverage plans and Benefit Functions to guide patients.
• Ability to manage Paperwork efficiently, ensuring all forms are correctly filled out and filed.
• Experience in Perform Ad Hoc Financial tasks to support the finance department.
• Familiarity with Claim Administration procedures within the healthcare industry.
• Proficient in English Language, both written and spoken.
• Exceptional Communication Skills to deal with patients, their families, and healthcare professionals.
• Proficiency in Spanish Language is a plus, as it may help in communicating with a wider range of patients.
• Regular Attendance is crucial, as the role demands a strong presence in the office.
• Proficient in Microsoft Office Suites, especially Word, Excel, and Outlook.
• Prior experience in Interviewing for hiring new staff members is a plus.
• Familiarity with HealthCare.gov for accessing necessary information and resources.
• Experience in obtaining necessary Authorizations for medical procedures.
• Familiarity with Metrics used in healthcare to measure performance and quality.