Reimbursement Call Center Customer Service Counselors

Company Description

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.

Job Description

Our client in Rockville, Maryland, is looking to hire 32 contract Reimbursement Call Center Customer Service Counselors for 3 months. The role could be extended up to 6 months and some of the positions could go permanent. The start date for the training class is November 1, 2016.

Rockville, MD 20850

Payrate: $18 per hour

Candidates must be flexible to work any of these shifts: 9:00am-6:00pm, 10:00am-7:00pm and 11:00am-8:00pm. Training will be 9:00am-6:00pm for the first 6 weeks of the assignment.

Please Note: Nearest Metro stop is Shady Grove off the Red Line and you would need to take the 66 bus route to get to the client site.

Benefits while temporary include: A Kelly Service Representative who is dedicated and assigned specifically to your client site to help you network for additional opportunities; Medical/Dental/Vision coverage options through Kelly Services; Weekly compensation (paycheck)

This role will involve a combination of taking inbound calls, making outbound calls and document review

Responsible for various reimbursement functions, including but not limited to:

- Accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.

- Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.

- Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.

- Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.

- Researches and resolves any electronic claim denials.

- Researches and resolves any claim denials or underpayment of claims. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.

- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

- Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.

- Reports any reimbursement trends/delays to supervisor e.g. billing denials, claim denials, pricing errors, payments, etc.

- Processes any necessary insurance/patient correspondence.

- Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification NPI number, and referring physicians.

- Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.

- Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

- Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims.

- Works on problems of moderate scope where analysis of data requires a review of a variety of factors.

- Exercises judgment within defined standard operating procedures to determine appropriate action. Typically receives little instruction on day-to-day work, general instructions on new assignments. Performs related duties as assigned.

Must-Have Requirements:

High School Diploma or G.E.D. equivalent with documentation

Call Center and Healthcare experience of at least a year

Experience working in a Customer Relationship Management Database (CRM) such as Salesforce or a company-specific program

Preferred Requirements:

Lash experience

Candidates should also have:

Strong organizational skills; attention to detail.

General knowledge of accounting principles, pharmacy operations, and medical claims.

General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred.

Global understanding of commercial and government payers preferred.

Ability to proficiently use Microsoft Excel, Outlook and Word.

Professional expertise; applies company policies and procedures to resolve a variety of issues.

Ability to communicate effectively both orally and in writing.

Ability to build productive internal/external working relationships.

Strong interpersonal skills. Strong negotiating skills. Strong mathematical skills.

Additional Information

Instructions :Please call 641-424-3614 for more information on how to apply!

Why Kelly?

As a Kelly Services candidate you will have access to numerous perks, including:

Exposure to a variety of career opportunities as a result of our expansive network of client companies 

Career guides, information and tools to help you successfully position yourself throughout every stage of your career

Access to more than 3,000 online training courses through our Kelly Learning Center

Group-rate insurance options available immediately upon hire*

Weekly pay and service bonus plans