Overview :
The Revenue Cycle Manager Customer Service Specialist role is a key liaison between patients, insurance carriers, and internal departments. The Customer Service Specialist will be responsible for providing exceptional customer service while managing patient inquiries related to accounts, insurance, and billing. They serve as an RCM expert and resource to Billing Call Center, Operations and Resource Center teams for patient related billing inquiries.
This is a remote role only for : IL, OH, WV, PA, MI, GA ONLY
What You Will Be Working On :
Performance
- Handles customer calls to resolve inquires in a timely and accurate manner in a patient focused manner that enhances the experience of patients and their families.
- Assist patients with billing inquiries in a professional and empathetic manner
- Verify insurance information and assist in claim resolution, including following up on unpaid or denied claims
- Post payments and adjustments to patient accounts accurately
- Identify and escalate complex issues to the billing supervisor or the appropriate department
- Process refunds, payment plans, and account corrections when necessary
- Document all communication and actions in the patient's account in a clear and timely manner
- Support the billing team with clerical tasks such as filing, faxing, and data entry
- Support Operations by providing live support when urgent escalations exist at a place of service
- Collaborate with clinical and administrative teams to resolve patient concerns quickly and effectively
- Maintain confidentiality and adhere to HIPAA regulations at all times
Communication and Working Relationships
Works cross-functionally to maintain and promote an efficient and effective patient inquiry resolution processResponds to inquiries from leadership, Operations, staff or physicians in a timely and appropriate mannerCoordinate communication to leadership of root cause assessment that is contributing to recurring patient escalationsOther
Perform other duties as assignedExperience and Knowledge
High school diploma or equivalent required; associate degree or higher preferredMinimum 2 years of experience in a medical office or healthcare billing settingStrong understanding of medical billing processes, terminology, and insurance (commercial and government)Knowledge of CPT, ICD-10, and HCPCS codesExcellent verbal and written communication skillsAbility to multitask and remain calm in a fast-paced environmentProficient in using billing software and Microsoft Office Suite (especially Excel and Outlook)Experience with electronic health records (EHR) and practice management systems is a plusPreferred Skills
Bilingual (English / Spanish or other) is a plusOphthalmology and / or Ambulatory Surgery Center billing experienceFamiliarity with the appeals and denials processJob Posted by ApplicantPro