Healthcare Call Center Representative (REMOTE)

Job Summary

The Healthcare Call Center Representative (REMOTE) is the primary point of contact for customers, handling inquiries, providing information, resolving issues, and ensuring a positive customer experience. This role requires strong communication skills, attention to detail, and the ability to handle a variety of customer requests in a professional and efficient manner. The Customer Service Representative I will work closely with other team members and departments to address customer needs and ensure satisfaction.

Essential Functions

• Handles customer interactions through multiple communication channels, proficiency in written and verbal communication is crucial for this role.
• Serves customers by clarifying customer inquiries, determine the cause of the customer inquiry, provide best solution to resolve the customers inquiry.
• Provides triage support services to perform resolution on common issues related to platforms, user apps and back-office processes.
• Resolves, expedites corrective action or escalates customer inquiry to next level for resolution.
• Adheres to quality measures and standards captured through quality monitoring and evaluations.
• Documents timely, complete and accurate actions, including issue and resolution in systems.
• Customer Service representatives work in a performance driven environment guidd by specific metrics and standards used to measure productivity and quality of service
• Performs other duties as assigned.
• Complies with all policies and standards
• Answer in-bound calls to Shared Services Center - Nashville from patients, insurance companies and attorneys.
• Make out-bound calls to collect on early out self-pay patient balances.
• Perform insurance follow up to address customer concerns and based on the calls whether inbound or outbound and will research customer billing concerns per payer and create appropriate adjustments as needed.
• Ensure created adjustments receive proper approval and sign off.
• Address coordination of benefits issues with patients.

Qualifications

• H.S. Diploma or GED required
• Associate Degree in customer service, business, or a related field preferred
• 1 year of experience in a hospital or physical business office preferred
• 1 year of experience in call center with background of productivity expectations with high call volumes including customer correspondence
• 1 year of experience with medical revenue cycle processes from scheduling through agency placement and final account disposition
• Knowledge of insurance collection follow up or self-pay collections
• Experience and knowledge about EOB, Remits, and UB-04s preferred

Knowledge, Skills and Abilities

• Strong verbal and written communication skills with the ability to interact professionally with customers.
• Experience using customer service software, call management systems, enterprise (ERP) wide platforms, or CRM tools is a plus.
• Proficient in Microsoft Office Suite (Word, Excel, Outlook), Google Suite, and customer management systems.
• Ability to remain calm and professional under pressure in a fast-paced environment.
• Excellent problem-solving skills and the ability to handle difficult or challenging situations.
• Detail-oriented with strong organizational and multitasking abilities.