Customer Service Representative

MedReview•New York, NY

9d•Onsite

About The Position

Under the direction of Customer Service leadership, the Customer Service Representative is responsible for responding to customer inquiries, researching and resolving issues, supporting medical record retrieval activities, and ensuring a high level of service to clients, providers, and members. This position requires strong communication skills, attention to detail, and the ability to effectively manage multiple priorities while maintaining HIPAA compliance.

Requirements

High school diploma or equivalent required.
Previous experience handling medical records required.
Knowledge of HIPAA privacy and security requirements.
Proficiency with Microsoft Office applications, including Outlook, Word, and Excel.
Strong verbal, written, interpersonal, and customer service skills.
Excellent problem-solving, organizational, and time management abilities with the ability to manage multiple priorities independently.
Ability to maintain professionalism, confidentiality, and attention to detail in a fast-paced environment.
Ability to remain seated for extended periods and perform frequent computer, telephone, and data-entry tasks in an office environment.

Nice To Haves

Customer service, call center, healthcare administration, or related experience preferred.
Familiarity with healthcare claims processing, claim auditing, DRG Validation, Cost Outlier Reviews, and Readmission Reviews preferred.

Responsibilities

Answer incoming customer calls and respond to email inquiries in a professional, accurate, and timely manner.
Research customer concerns and provide appropriate information and resolution.
De-escalate customer issues and coordinate with internal departments as needed.
Review customer and client accounts and provide updates regarding claim audits, review statuses, and related inquiries.
Conduct outbound calls to providers to request medical records and supporting documentation required for review.
Verify provider contact information and ensure proper handling of confidential and protected information.
Assist users with navigating company websites, portals, and communication platforms.
Document customer interactions and maintain accurate records within company systems.
Transcribe and enter call-related information as required.
Collaborate with internal teams to improve customer service and operational efficiency.
Maintain compliance with HIPAA and all company privacy and security requirements.
Perform additional projects and duties as assigned.