Customer Service Specialist

ActivStyle•Las Vegas, NV

22d•$20 - $23•Onsite

About The Position

🌟 Looking for a full-time, in-office role where your work truly matters? At ActivStyle, we’re driven by purpose—and we’re looking for compassionate, motivated professionals to join us full time in our, Las Vegas, Nevada office . As a trusted provider of home-delivered medical supplies, ActivStyle helps individuals live with dignity, independence, and comfort. We’re currently hiring a Customer Service Specialist (Full-Time, Onsite) who will serve as the friendly voice and knowledgeable guide for our clients. In this role, you’ll support customers by helping them access essential products such as incontinence supplies, urological items, and other personal care needs—all delivered discreetly to their homes. You’ll work alongside a supportive, mission-focused team in a collaborative in-office environment where your impact is felt every day. If you’re passionate about helping others and thrive in a professional, people-first workplace, we’d love to welcome you to the ActivStyle family. Position Summary: Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls. Maybe responsible for obtaining, analyze, and verify the accuracy of information received from referrals, create orders, and or schedule the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate Patients of their financial responsibility when applicable.

Requirements

Excellent customer service skills
Analytical and problem-solving skills with attention to detail
Decision Making
Excellent ability to communicate both verbally and in writing
Ability to prioritize and manage multiple tasks
Proficient computer skills and knowledge of Microsoft Office
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to work independently as well as follow detailed directives
Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
Computer skills including knowledge of Microsoft Office applications
High School Diploma or equivalent required & One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry.
Associate's degree in a field of study related to patient healthcare.
Senior level requires two (2) years of work-related experience and one (1) year of exact job experience.
Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.

Responsibilities

Develop and maintain working knowledge of current products and services offered by the company
Answer all calls and emails in a timely manner, in adherence to their goals
Document all call information according to standard operating procedures
Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
Process orders, route calls to appropriate resource and follow up on customer calls where necessary
Review all required documentation to ensure accuracy
Accurately process, verify, and/or submit documentation and orders
Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required
Must be able to navigate through multiple online EMR systems to obtain applicable documentation
Enter and review all pertinent information in EMR system including authorizations and expiration dates
Communicate with Customer Service and Management on an on-going basis regarding any noticed trends with insurance companies
Verify insurance carriers are listed in the company’s database system, if not request the new carrier is entered
Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process.
Meet quality assurance requirements and other key performance metrics
Facilitate resolution on customer complaints and problem solving
Pays attention to detail and has great organizational skills
Actively listens to patients and handle stressful situations with compassion and empathy
Flexible with the actual work and the hours of operation
Utilize company provided tools to maintain quality. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and “How-To” documents
Develop and maintain working knowledge of current HME products and services offered by the company.
Maintain patient confidentiality and function within the guidelines of HIPAA.
Completes assigned compliance training and other educational programs as required.
Maintains compliant with ActivStyle’s Compliance Program.
Assist operations with on-call responsibilities as needed during non-business hours in accordance with company policy.
Depending on the geographic territory and size of the branch location, may require assisting operations with deliveries.
Retain knowledge of and consistently adhere to procedures for the use of Personal Protective Equipment (PPE), infection control and hazardous materials handling.
Perform other related duties as assigned.