Customer Care Specialist

JOB PURPOSE: The customer care specialist is responsible for ensuring excellent customer satisfaction through timely, accurate, and professional follow-up and resolution to customer complaints, issues, and general inquiries. Identification, validation and assignment of patient medical insurance for healthcare claims.

JOB FUNCTIONS:

• Provide exceptional customer service and support to patients and providers
• Assist patients with understanding their statements and resolution of billing issues
• Establish payment arrangements and process payments over the phone and in person
• Identify and gather new insurance information, which includes screening for charity, answering patient’s questions, and resolving any of the patient’s account issues
• Accurate verification of all insurance eligibility through payer portals, and entry of new or updated insurance information for all patient accounts
• Analyze patient insurance(s), identifies the correct insurance plan, and documents the correct insurance order
• Responsible for ensuring billed charges are allowable per payer policies
• Initiates outreach to patients to validate incomplete insurance information
• Demonstrate full understanding of EOBs to ensure accurate patient communication
• Work task queue assignment within the practice management system
• Handle inbound and outbound customer service calls regarding billing inquiries
• Responsible for validating referrals and authorizations for procedures and services, as required
• Retrieve required patient demographics and other data from all facilities for input into the practice management system
• Maneuver between software systems
• Review and distribute incoming correspondence
• Maintain accurate records of customer interactions and transactions
• Document clear, concise, and complete follow-up notes in system for each account worked
• Partner with other billing and practice site staff to resolve complex matters
• Assist in the development and ongoing assessment of policies and procedures
• Meet department standards for both production and quality
• Immediately identify and communicate problems to team members and management
• Attend monthly meetings to keep abreast of policy changes and billing department issues
• Other duties as assigned