Health Care Customer Service Representative Job Description

The health care customer service rep is a patient advocate.

The health care customer service rep is the person who answers the phone, greets patients, and responds to inquiries from patients or referring physicians.

The health care representative’s main duties include ensuring that the patient is satisfied with the visit and that quality care was provided.

The health care customer service rep must be able to address the concerns of the patient and refer any problems to the provider to make sure the patient is receiving the best care possible.

Updated on:     
September 15, 2022

Job Brief:

We're looking for a motivated and experienced Health Care Customer Service Representative to join our team. In this role, you will be responsible for providing exceptional customer service to our clients. You will be the first point of contact for our clients and will be responsible for handling a wide range of customer service inquiries. We are looking for someone who is able to work independently and is able to take initiative in resolving customer issues. If you are a team player and are passionate about providing outstanding customer service, then we want to hear from you!

Health Care Customer Service Representative Duties:

  • Answer and review customer service calls related to and resolve a variety of customer inquiries and concerns
  • Provide 24/7 coverage by responding to client needs
  • Adhere to legal regulations, building and safety codes, and other requirements
  • Operate computer databases, perform telephone activities and use office equipment
  • Follow established company policies, procedures, and guidelines

Health Care Customer Service Representative Responsibilities:

  • Answer incoming customer inquiries regarding coverage, benefits, and billing, and escalate issues to appropriate personnel
  • Provide hands-on customer service, including customer transactions, prior authorizations, denial and appeals, and case inquiries
  • Manage triage to ensure incoming cases are responded to in a prompt, accurate, and empathetic manner
  • Assist in online billing and account management, including eligibility verification, claim submission, and claim status
  • Work with external service providers to resolve claims issues and create positive customer relationships

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Requirements And Skills:

  • High school diploma or GED
  • 1-3 years’ customer service experience
  • Proven track record of providing excellent customer service
  • Ability to communicate effectively in English and Spanish
  • Knowledge of medical terminology
  • High level of attention to detail and the ability to maintain quality standards
  • Ability to multi-task effectively

At [Company Name], we value diversity and inclusion in the workplace. We are equal opportunity employers, and we are committed to building a team that reflects the diversity of the communities we serve. We encourage applications from people of all races, religions, national origins, genders, , , gender expressions, and ages.

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