Customer Service Expert (Remote) - Claims Details

Customer Service Expert (Remote) - Claims

CareCentrix - Remote

Employment Type : Full-Time

Overview: As a Healthcare Customer Service Expert, you have the opportunity to be the first point of contact for patients/providers needing home healthcare services. You will be responsible for receiving and responding to incoming /outbound calls from Patients/providers, referral sources and potential patients/Providers by collecting and entering clinical and demographic information into our CareCentrix portal. Typical phone calls range from interactions with customers/providers who need basic information, to assisting those with more complex requests. claim status (payment, denials, rejections, appeals, recoupments, etc.), education on Explanation of Payments and provider portal questions, and other concerns and/or complaints. The more challenging calls can be the most rewarding because you know you are making a difference to a customer or patient that needs your help.Responsibilities: In this Job you will:

• Researches, resolves, and documents patients/Providers inbound and outbound calls involving a wide range of issues utilizing multiple information systems. This includes communications with internal business centers and external customers. Assures customer agreement by summarizing and closing each call appropriately.
• Handles various communication channels with providers, including inbound and outbound provider calls which involve researching, resolving, and documenting issues.
• Analyzes data and determines if CareCentrix claims processing guidelines have been followed correctly by researching plan, eligibility, and patient authorization information.
• Investigates payment status and determines ultimate patient financial responsibility. Collect outstanding balance, offer patient assistance with financial responsibility through various financial options.
• Maintains patient/provider confidentiality and data integrity in accordance with Health Information Portability Accountability Act (HIPAA), and company policies and procedures.
• Exercises good judgment, interpret data, and remains knowledgeable in details of all related CareCentrix contracts, policies and procedures. Participates in process improvement initiatives; maintains teamwork, customer service production and quality standards to assure timely, efficient and accurate call resolution.
• Minimize patient dissatisfaction with active listening, maintaining a professional tone, and acknowledging their concerns.

• You are passionate about health care and believe that one of the best ways to do that is by helping improve the quality and access to care in the home.
• You enjoy working in a fast-paced environment
• You are accurate with strong attention to detail
• You have the ability to communicate professionally
• You are fun to work with! We take our commitment to patients seriously, but we don't take ourselves seriously
• We are looking for team members who bring joy to the work they do.

• High School Diploma or GED.
• Minimum 1 year work experience.
• Good computer skills
• Great communication and problem solving skills
• Embracing the values of accountability, consistency and engagement through excellent attendance
• Excellent customer service through the ability to care for others
• Flexibility, adaptability and motivation learn

• Starting Pay for external hires is $16.35/hr + Monthly Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
• Profit Sharing, generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
• Advancement opportunities, professional skills training, and tuition Reimbursement
• Great culture with a sense of community.

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.