HCS Customer Service Specialist II

Job Description:

  • Provide professional, accurate and timely responses to CMS (Medicare) and provider inquiries.
  • Maintain a current knowledge of all contract requirements and objectives.
  • Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors.
  • Take inbound calls from providers to answer questions and resolve complex issues.
  • Make outbound calls to healthcare providers to confirm if letters requesting records for review have been received.
  • Respond to assigned written communications from providers timely and accurately.
  • Educate providers on proper process protocols and their appeal rights.
  • Establish appropriate contacts and perform necessary research to validate provider contact information.
  • Enter and update all contact and activity information into tracking logs and the audit platform.
  • Research and route internal/external communications to the appropriate person or department.
  • Notify management of escalated displeasure, legal action, government intervention, or suggestions for process improvements.

Requirements:

  • At least two (2) years’ experience in a call center or customer service position required.
  • At least one (1) year claims processing/billing experience preferred.
  • High School diploma or GED is required.
  • Must maintain HIPAA Certification.

Benefits:

  • medical
  • dental
  • vision
  • HSA/FSA options
  • life insurance coverage
  • 401(k) savings plans
  • family/parental leave
  • paid holidays
  • paid time off annually
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