Customer Service Representative (Medical Billing)

Gryphon Healthcare • Houston, TX

5d • Onsite

About The Position

The Customer Service Representative responds to patient account inquiries in compliance with corporate collections policies, processes patient payments, and generates patient statements. The role is a first point of contact for clients and patients, providing service and support while resolving billing questions and issues. It also supports the Medical Records Department by retrieving records for patients, attorneys, and third-party vendors.

The representative reviews and researches healthcare claims using multiple computer systems and platforms, ensures benefits are applied through appropriate procedures, documents interactions, and follows problems through to resolution. The position requires clear, sensitive communication with patients about bills and statements, attention to service and performance goals, and continued learning about medical billing regulations and trends. The role is based in Houston, Texas, and operates in a fast-paced, high-volume environment; hours may need to be adjusted and overtime may be needed to respond to changing workload needs.

Requirements

• High school diploma.
• At least 1 year of customer service experience in a medical environment, such as a clinic, hospital, or ER.
• Knowledge of customer service principles and processes.
• Knowledge of medical billing and collection practices.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to maintain patient-data and medical-record confidentiality in compliance with HIPAA guidelines and regulations.
• Experience or familiarity with EMR, EDI, and commercial insurance company systems.
• Professionalism and ability to handle patient issues with sensitivity and confidentiality.
• Detail-oriented, accurate data entry skills.
• Strong organizational skills and ability to prioritize workload.
• Ability to write and speak effectively in English.
• Interpersonal skills to work with all levels of the billing and management team.
• Ability to work well in a team environment.
• Basic computer literacy, including keyboarding, Outlook, and navigating a Windows environment.
• Ability to flex hours and work overtime to meet needs related to unanticipated volume, changes, or problems.

Nice To Haves

• Bilingual skills.
• Experience verifying medical insurance.
• Ability to interpret Explanation of Benefits (EOBs).
• Prior call center experience.

Responsibilities

• Answer incoming customer calls and determine the assistance needed.
• Ask appropriate questions, listen actively, and document required information in computer systems.
• Take ownership of customer and patient issues through timely follow-up and resolution.
• Review and research patient healthcare claims using multiple computer systems and platforms.
• Apply appropriate benefits to claims using established processes and procedures.
• Communicate and collaborate with patients to resolve issues and explain bills or statements clearly.
• Meet performance goals for efficiency, accuracy, quality, member satisfaction, and attendance.
• Identify and resolve patient billing issues.
• Provide excellent customer service to patients over the phone.
• Continue medical education to stay current on medical billing issues, trends, laws, and regulations.
• Support other billing department team members as needed.
• Retrieve medical records for patients, attorneys, and third-party vendors.
• Process patient payments and generate patient statements.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED