Demo

Customer Experience Specialist

Prometheus Labs
San Diego, CA Full Time
POSTED ON 3/4/2025
AVAILABLE BEFORE 6/4/2025

SUMMARY

The Reimbursement- Customer Experience Representative will report directly to the Customer Experience Supervisor while working closely with Billing, Sales and other Commercial personnel to support commercial and financial objectives through strategic and tactical activities, actively engaging with current customers, and provide the highest level of customer service to ensure long-term relationships and retention.

The Reimbursement -Customer Experience Representative must be solutions oriented and will support our inbound and outbound phone lines to engage in operational and administrative processes associated with Insurance and direct bill reimbursement orders. This role is responsible for delivering a world-class Customer Experience model that is ahead of the curve to anticipate changes in customer needs, prepared to expand quickly and efficiently, and considered the best in the industry.

The Reimbursement- Customer Experience Representative should be prepared to handle multiple tasks, to answer to a variety of queries that will come from a diverse Customer base that may include health care professionals, patients and their family members, insurance company claims managers, internal sales representatives, and others.

Essential Duties

include but are not limited to the following :

  • Support all Inbound and Outbound phone line responsibilities with urgency and excellence.
  • Inspire and drive a customer success culture across the commercial organization.
  • Identify and execute effective first contact resolutions to address all client's critical inquiries.
  • Advocate customer needs through cross-functional internal partnerships with commercial, services, operations, and logistics.
  • Document case and claim accounts to feed critical data for inside sales and all business initiatives.
  • All action taken will be a measure of effectiveness of the account management; be responsible for identifying and communicating claim and account level issues to leadership as appropriate.
  • Partner with the Customer Service team to develop efficiency and process improvements to enhance the customer experience.
  • Handle and resolve escalated complex customer requests or complaints, as appropriate.
  • Follow all compliance and HIPAA standards when documenting all calls according to Customer Service Policy and Procedures.
  • Help resolve any deficiency for all orders, including assistance with the retrieval of clinical and demographic information and collaborating with field sales to ensure the ordering experience of the customer is seamless, timely and effective.
  • At times, represent Customer Experience in inter-departmental meetings, conference calls, and presentations.
  • Triage inquiries and escalate as appropriate to the person, office or department accordingly, while supporting a seamless experience for the customer.
  • Ability to handle multiple projects at the same time but remain organized, strong sense of urgency for schedules.
  • Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
  • Regular and reliable attendance.
  • Excellent verbal and written communication skills and the ability to work in multiple systems interfaces at one time.

Minimum Qualifications

  • High School Degree / General Education Degree and 4 years of relevant experience in Customer Service, medical industry Customer call center or relevant experience as outlined in the essential duties in lieu of bachelor's degree.
  • 4 years of experience in customer service and call center responsibilities.
  • Demonstrated ability to think critically and apply customer lens judgement in actioning and resolving inquiries.
  • Strong understanding of customer service, medical billing, insurance, and data entry.
  • Advanced proficiency in customer service systems, CRMS, Phone systems, Billing Platforms.
  • Fluency in English required. Spanish / Bilingual a plus
  • Proficiency in Microsoft Office, to include Word, Excel, Outlook, SharePoint.
  • Demonstrated ability to perform the Essential Duties of the position with or without accommodation.
  • Maturity and good judgment to understand when to exercise initiative and handle queries directly, and when to escalate queries to higher authority.
  • An excellent team player - highly effective at working with others and capable of working independently most of the time.
  • Ability to multi-task and an attention to detail. Must be able to work in a fast paced, time-sensitive environment.
  • A deep understanding of drivers of customer satisfaction and an overt willingness to be an internal champion for both the field sales team and health care providers.
  • Strong customer service orientation and willingness to prioritize the needs of those seeking information from the Company. Conflict resolution skills a must.
  • Must have superior interpersonal and organizational skills. Excellent listening, oral and written communication skills. A high level of empathy, enthusiasm, and self-confidence.
  • Professional telephone manner.
  • Preferred Qualifications

  • Clinical / Medical or other ancillary service type background.
  • Minimum of 4 years Customer Service experience in Health Care, Lab, DME Pharmaceutical industry preferred.
  • Bachelor's Degree preferred.
  • Significant PC knowledge & Windows OS experience. Skilled competence with Five9, Cisco or other phone systems, Microsoft Office, Salesforce.com a plus.
  • All qualified applicants are considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status or other protected class.

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