What are the responsibilities and job description for the Customer Care Support Specialist position at Duly Health and Care?
Location: Hybrid, Remote - Mandatory training in Lisle, IL.
Hours: Mon-Fri 8:30a-5:00p
Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your mark!
Holistic benefits designed to help our team members flourish in all aspects of their lives, including:
- Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.
- $5,250 Tuition Reimbursement per year.
- 40 hours paid volunteer time off.
- A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact
- 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members.
- 401(k) Match
- Profit-sharing program
Are you ready to challenge the expected to deliver the extraordinary?
The Customer Care Support Specialist handles incoming calls for eligibility, claims status, and referral questions assisting with patient care. The Customer Care Support team is set up to ensure prompt, courteous service to all customers; patients, vendors, health plans and clinic employees. The Customer Care Support Specialist is responsible for handling capitated questions as well as questions related to billing and referrals for contracted clients
Responsibilities
- Provides exemplary Customer Care Support to patients, providers and employees for Duly Health and Care and clients
- Answers patient questions, inquires, and concerns regarding their accounts.
- Works with patients and providers to resolve account challenges and communicate appropriate next steps for troubleshooting
- Identifies potential revenue cycle challenges and escalates to departmental and/or leadership review as necessary
- Identifies insurance errors and is responsible for updating and loading insurance.
- Responds to voice mail messages, My Chart Inquires, requests from Duly Health and Care Website and Patient Correspondence within 48 hours.
- Responds to client relation management messages and MyChart communication within a specified turnaround time
- Answers patient questions on information regarding physicians and our locations/sites.
- Provides capitated medical claim status to contracted providers.
- Updates Primary Care Physician change requests from patients.
- Provides Referral and Authorization Status to patients and providers for capitated and non-capitated plans.
- Reviews billing transactions for accuracy and to help resolve payment posting challenges on accounts
- Liaises with Utilization Management to assist with appropriate resolution of authorization challenges, timelines, and execution
- Reviews insurance portal benefit information for appropriate communication with patients and clients
- Providers capitated claim status to contracted providers and discussion of capitation procedures
Qualifications
Level of Education
High School/GED
No certification, registration or license required
Years of Experience
2-5 years experience in membership, customer service, and/or healthcare billing
