Customer Service Representative
The Customer Service Representative answers patient calls regarding their medical bills, insurance Explanation of Benefits (EOB) forms, and bill payment arrangements. Researches and documents incoming calls and correspondence.
Essential Functions & Responsibilities
- Provides exceptional customer service to patients. Asks questions to troubleshoot billing inquiries, explains benefits coverages, and explains the problem-solving process and timeframes. Escalates issues as appropriate.
- Ensures proper documentation, recording, and closure of issues.
- Performs special projects and other duties as assigned.
- Education: High School Diploma or Equivalent.
- Experience: One (1) year of call center customer service experience in a high volume, fast paced environment. Healthcare call center experience preferred.
Knowledge, Skills, and Abilities
- Knowledge of the Explanation of Benefits
- Knowledge of a variety of insurance plans
- Knowledge of ICD-10 and CPT Codes
- Strong word processing, spreadsheet, database, and presentation software skills
- Strong mathematical skills in addition, subtraction, multiplication and division of whole numbers and fractions; computing percentages; and working with decimals
- Strong oral, written, and interpersonal communication skills
- Strong time management skills
- Strong organizational skills
- Ability to handle and resolve escalated calls and correspondence
- Ability to read, understand, and apply state/federal laws, regulations, and policies
- Ability to remain flexible and work within a collaborative and fast paced environment
- Ability to communicate with diverse personalities in a tactful, mature, and professional manner