Customer Care Specialist

Inspire Health Medical Group•Fresno, CA

12d•$24 - $26•Onsite

About The Position

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.

Requirements

High school diploma or equivalent, with additional specialized training
Minimum four (4) years of customer service experience using a computerized accounts receivable system in a medical or hospital setting performing billing functions
Minimum two (2) years of experience utilizing insurance payer portals
Experience in handling confidential data, patient demographic information
Knowledge of common insurance plans (i.e. HMO, PPO, Medicare, Medi-Cal)
Basic Microsoft Excel and Word knowledge
Knowledge of medical insurance and authorization process
Bilingual in Spanish required
Excellent organization and time management skills
Strong verbal and written communication skills
Attention to detail and ability to handle sensitive information
Ability to remain focused and productive each day as tasks may be repetitive
Ability to effectively work and communicate with coworkers, patients, and outside agencies
Ability to present oneself in a courteous and professional manner at all times
Ability to prioritize multiple tasks in a busy work environment
Ability to work independently as well as in a team-based environment

Nice To Haves

Basic CPT-4 and ICD-10 knowledge preferred

Responsibilities

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