Customer Service Rep - Part - Time

CCS Medical•Clearwater, FL

12h•Remote

About The Position

CCS is redefining chronic care management through its patient-centric approach to at-home care. The Customer Service Representative plays a crucial role in supporting accurate and timely pharmacy order processing. This involves resolving patient issues, handling calls, validating medical documentation, and assisting patients with understanding order status, documentation needs, and insurance coverage. The role requires collaboration with patients, physicians, referral sources, pharmacy technicians, and pharmacists to ensure a positive customer experience while adhering to company procedures, documentation requirements, and payer guidelines. This is a part-time, remote position, with the requirement to attend training in the Clearwater, FL office for the first month.

Requirements

High school diploma or GED equivalent required.
Minimum of 6 months of experience in health care insurance verification, order processing, call center customer service role preferred.
Ability to navigate multiple systems, digital platforms/databases and Microsoft products.
Basic knowledge of billing procedures, insurance reimbursement processes, government payer requirements, private insurance requirements, and HCPC codes preferred.
Strong attention to detail, data entry accuracy, organization, follow-through, multitasking, communication, and problem-solving skills required.
Ability to communicate professionally and empathetically with patients, healthcare professionals, manufacturing partners, sales teams, and other internal stakeholders.
Ability to build confidence in patient care by consistently following through, communicating with transparency, and completing each task with accuracy, precision, and accountability.
Ability to take ownership of outcomes from start to finish by following documented processes first, resolving work within scope, and escalating issues appropriately only when additional support is needed.
Ability to work in a fast-paced, high-volume environment while maintaining confidentiality, compliance, regular attendance, and flexibility to meet department needs, including possible evening or weekend availability.
Must live in Clearwater area, as training is conducted in office.

Nice To Haves

Minimum of 6 months of experience in health care insurance verification, order processing, call center customer service role preferred.
Basic knowledge of billing procedures, insurance reimbursement processes, government payer requirements, private insurance requirements, and HCPC codes preferred.

Responsibilities

Conduct all patient order processing activities including updating patient demographics, explaining benefit details, obtaining patient consent, communicating order status, and processing payment.
Maintain patient profiles, manage enrollments, and support basic workflow creation in accordance with business processes, payer requirements, and department procedures.
Navigate and maintain work activity within iPIMS, Parachute Health, email, To-Do queues, and other digital platforms to support accurate documentation, order processing, and workflow completion.
Obtain, process, and validate required patient consents, including non-verbal consent, portal consent, secure form consent, and reorder agentless consent, in accordance with company procedures, payer requirements, and applicable privacy standards.
Monitor, manage, and resolve assigned work queues to ensure timely issue resolution and workflow completion.
Handle inbound and outbound patient service interactions, including insurance explanations, service additions, payment processing, patient account review, triage, escalation, and resolution of patient or order-related issues.
Drive favorable NPS and CSAT scores.
Maintain working knowledge of core product lines, assigned products, basic product identification, and documentation requirements by product type to support accurate order processing and patient education.
Build and maintain professional relationships with patients, healthcare professionals, manufacturing partners, sales teams, Revenue Cycle Management, Distribution, and other internal stakeholders.
Abide by all company policies, procedures, and standards, including Medicare, Medicaid, HIPAA, and private insurance regulations.
Always maintain a high degree of confidentiality due to access to sensitive information.
Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department.