Customer Service Representative I or II - Medical Billing

Chesapeake Employers Insurance•Towson, MD

1d•Onsite

About The Position

This role serves as the primary point of contact for medical providers, addressing inquiries related to the submission and payment of medical bills. The Customer Service Representative ensures timely, accurate, and courteous responses, acting as the "front-line" for customer interaction within the Medical Billing Department. The position requires a strong understanding of workers' compensation insurance, company procedures, and effective communication skills to support both external customers and internal business partners. For the Customer Service Representative II role, the focus is on resolving customer requests ranging from basic to complex, requiring advanced business knowledge to achieve first contact resolution.

Requirements

A High School Diploma or equivalent is required.
2 to 3 years as medical bill processor or adjudicator, preferred.
One year of customer service experience in insurance or health industry is preferred.
Excellent verbal and written communication skills required.
Basic skill in claims or medical billing systems applications required.
Basic PC skills required with a knowledge of MS Office Suite (Outlook, Teams, Word, Excel) is preferred.
At least 1 year experience in the Customer Service Representative I position with consistent performance at better.
2 or more years in medical bill processing.
Effectively demonstrated advanced call management techniques.

Nice To Haves

Two or more years of college is preferred.
Bi-lingual Spanish speaking preferred.
CPC preferred.
AA Degree

Responsibilities

Provides first contact resolution to external customer inquiries received by phone.
Applies call techniques, protocols and knowledge of workers compensation insurance, along with Standard Operating Procedures, company organizational structure and individual operation roles.
Responds to inquiries from claimants, medical providers and other personnel regarding the payment for services provided under workers’ compensation.
Communicates with medical providers regarding the payment or denial of payment of bills.
Facilitates outbound calls to service providers.
Manages the customer service box and spreadsheet/Excel function.
Sorts, processes and sends out provider faxes.
Safeguards the privacy and security of client information by following company policies and procedures.
Actively supports company strategies and department goals.
Performs data entry of bills submitted for payment or reconsideration.
Maintains the integrity of the information system by accurately recording transactional information.
Processes bills submitted for medical treatment in accordance with established policies and the Workers’ Compensation Fee Guide.
Meets departmental guidelines for productivity and accuracy of payment of medical bills.