Payment Specialist/Customer Service Representative

Published June 28th, 2024

Customer Service Representative/Payment Specialist

Hours will be 3-days 11:30-8pm and 2-days 9:30-6pm (M-F) 40 hours.
Job Title:  Customer Service Representative/Payment Specialist
$19 to $22 hourly 

Summary:
Responsible for working in a fast paced environment and having strong interpersonal and communication skills, attention to details, outstanding ability to multi-task and prioritize and strong analytical skills.
Performs administrative tasks related to client health premiums and out of pocket medical expenses, interact with clients to provide information in response to inquiries about products and services, and handle and resolve complaints by performing the following duties.

Duties and Responsibilities include the following. 

  • Answers phones and respond to client inquiries related to payments made on their behalf to medical providers.
  • Answers phones and responds to medical provider inquiries related to payments made or due to their office on their behalf of program clients.
  • Makes outgoing calls to clients, medical providers and insurance companies or the like.
  • Identifies, researches, resolves client issues.
  • Promotes teamwork and service delivery success.
  • Responsible for being mindful of contractual performance guarantees related to payment processing timeliness and accuracy are met.
  • Responsible for being mindful of contractual performance guarantees related to various means of client communications are met such as phone, email, and mail.
  • Processes health and dental insurance premium payments for clients.
  • Processes medical payments for clients.
  • Creates and updates financial batch records for processing by accounting.
  • Audits payment files and outgoing payments and checks accuracy of figures calcuation.
  • Updates appropriate call logs.
  • Refers unresolved client grievances to designated departments for further investigation.
  • Works with clients that have high medical utilization.
  • Recognizes, documents, and alerts the customer service manager of call trends in client services.
  • Performs other duties as assigned.

Education/Experience:

  • Associate’s degree (A. A. / A. S.) or equivalent from two-year college or technical school; or two to four years related experience and/or training; or equivalent combination of education and experience.

Specialized Training:

  • Knowledge of medical insurance practices including enrollment, payment terms related to insurance premiums and out of pocket expenses, benefits coordination with other insurance coverage, and ensuring payer of last resort.

Certificates and Licenses:

  • Medical billing strongly preferred but not required

Knowledge, Skills, and Other Abilities:

  • Bilingual in English and Spanish strongly preferred but not required
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