Customer Service Representative (Healthcare)

Position: Customer Service Representative
Department: Operations
Reports To: Team Lead / Program Manager
Supervises: None

Primary Responsibilities:

• Data Verification: Conduct outbound calls to verify patient demographic details, eligibility for insurance, and benefits.
• Medical Billing Follow-ups: Monitor unpaid insurance claims and pending appeals. Request necessary records or denial documentation to be faxed and update account information in the management system with comprehensive notes.
• Document Management: Organize and maintain medical, demographic, and billing records, ensuring files are appropriately named and stored in internal systems.

Qualifications:

• Strong customer service skills.
• Proficiency in basic computer applications.
• Adequate English communication skills.
• High attention to detail.
• At least 6 months of experience in customer service or outbound (non-sales) roles.

Key Performance Metrics:

• Accuracy
• Attendance
• Reliability
• Productivity

Work Schedule:

• 12:30 AM to 9:30 AM (Tuesday to Saturday)
• Schedule may be adjusted based on business requirements