Customer Service Specialist
$35,360–$35,360 year
On-siteBrevard, North Carolina, United States
Job Summary
Answer inbound and outbound calls to serve as a trusted resource for clients obtaining vital home-delivered medical supplies. Obtain, analyze, and verify information from referrals, create orders, and schedule patient equipment delivery based on physician directives. Process orders, route calls, and complete insurance verifications to determine eligibility, coverage, and deductibles. Obtain pre-authorizations, submit documentation to carriers, and navigate multiple EMR systems to track authorizations and expiration dates. Educate patients on financial responsibilities, resolve complaints, and facilitate referrals when documentation does not meet payer guidelines. Maintain patient confidentiality, adhere to HIPAA and compliance programs, and assist with on-call operations during non-business hours.
Required Qualifications
- High School Diploma or equivalent
- One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
- Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance
- Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
- Must be able to lift 5 to 10 pounds periodically as needed
- Must be able to navigate through multiple online EMR systems to obtain applicable documentation
- Must be able to effectively communicate both verbally and written with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy
- Mental alertness to perform the essential functions of position
- Ability to adapt and be flexible in a rapidly changing environment
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form
- Ability to work independently as well as follow detailed directives
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
- Must be able to handle stressful situations with compassion and empathy
- Must be able to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
- Must be able to effectively communicate both verbally and written with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy
Desired Qualifications
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
- Proficient computer skills and knowledge of Microsoft Office
- Computer skills including knowledge of Microsoft Office applications
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