Customer Service Representatives

Location: Monroeville, Pennsylvania
Posted On: 8/4/2017
Job Code: 4268_CSR_PA
Job Description
• Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.
• Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
• Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
• Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payers.
• Researches and resolves any electronic claim denials. Researches and resolves any claim denials or underpayment of claims.
• Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
• Provides all necessary documentation required to expedite payments.
• Coordinates with inter-departmental associates to obtain appropriate medical records as athey relate to the reimbursement process.
• Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.
• Communicates effectively to payers and/or claims clearinghouse to ensure accurate and timely electronically filed claims.
• Works on problems of moderate scope where analysis of data requires a review of a variety of factors.
Qualifications a
• Medical Insurance Knowledge
• Computer Skills
• Detail Oriented
• Results Driven
Category:Non-IT  code:new
Job Requirements
Focus,MS Outlook,MS Word

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Contact Details
Nishant Mehta
E-mail Address