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Medical Customer Service Specialist
Medical Customer Service Specialist
Department: Customer Service
Location: Winston-Salem, NC
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Answer & conduct phone calls in a timely, professional, and courteous manner and according to applicable compliance procedures and client specifications.
- Answer phone calls quickly and in a pleasant, professional manner
- Identify each caller’s needs and determine the next appropriate action, which may include clarifying charges/payments, collecting, adding, updating, and filing insurance, resolving complaints, and/or notifying supervisors/management of complaints that cannot be resolved on the first call
- Address each caller’s needs while being sensitive to the appropriate amount of time needed to complete and close the call in a courteous and professional manner
- Accurately document each call and the outcome in the Sanitas system in an efficient, clear, and concise manner. Documentation must be understandable if read at a later date and/or by another employee
- Identify appropriate situations for transferring/escalating a call to a senior advisor, supervisor or member of management
- Detect caller patterns and provide appropriate feedback to supervisor in order to reduce or prevent possible future calls
- Conduct all job tasks, duties, phone calls, and interactions with professionalism, respect, a positive attitude, and in accordance with company compliance policies and applicable government regulations
- Consistently support and demonstrate the company mission and values
- Perform administrative or billing-related tasks as directed
- Assist with special projects as directed
- Participation in relevant meetings or events
- Perform other necessary tasks as assigned by supervisor
- Completion of new hire billing training with at least 90% QA maintained
- Employee must learn to handle all types of calls/callers and still remain calm & professional while addressing the caller’s need in a timely manner
- Employees must maintain an acceptable production rate.
- Return all calls and follow up on all outstanding issues within 24 business hours
- Employeesare expected to successfully complete CS training and verify own work within 90 days of entering the CS Department.
- Employee must be in this role for at least 60 days before moving into CS Specialist I role. Rare exceptions may be made for internal hires, based on performance.
Required Education, Skills, & Experience
- High School diploma
- At least 1 year experience in a customer service role within a clerical/administrative environment
- Excellent customer service skills & telephone etiquette
- Strong & professional verbal, written, and telephone communication skills; this is normally acquired via one to three years of office experience.
- Working knowledge of Microsoft Office programs
- Dependable and reliable work attendance to ensure phone coverage
- Ability to function well within a cross-functional team setting and independently
- Ability to work independently with minimal supervision
- Must possess critical thinking/analytical skills
- Highly organized with ability to manage time and prioritize work well
- Must be able to handle disgruntled callers professionally, effectively, and with tact
- Strong data entry skills
- Strong preference for demonstrated understanding of Medicare, Medicaid, insurance, liability, tertiary payment methods, and HIPAA regulations
- Prior experience with medical billing or terminology either in an employment role or classroom setting
- Prior experience providing customer service in a production environment.
- Proficient in Sanitas software