The primary function of an Account Associate/Customer Service Representative is to take incoming calls/make outbound calls while researching and reviewing medical claims/ benefits for information. Associate will be contacting patients and payors to facilitate correct processing of claims.
• Contacting payors and patients to collect on outstanding claims
• Research claim denials on behalf of our clients, make determination on proper next step for claim resolution
• Update, correct and rebill medical claims according to proper billing guidelines
• Attention to Detail and Accuracy.
• System savvy – Multi applications.
• High Call Volumes (Inbound/Outbound).
• Process Daily Correspondence (Mail, Fax, and Emails)
• Provides assistance/resolution to client’s inquiries
• Uses appropriate systems for payment determination
• Supports and assists team members
• Maintain a current working knowledge of all healthcare related issues and regulations
• Documents response activities to patient claim inquires following Genpact client guidelines and system tasks and notes
• Performs other related projects and duties as assigned
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
• PC literate including AR software, Microsoft Office with strength in Excel
• Ability to handle calls in a fast paced call center environment
• Ability to handle irate callers in a professional manner
• Phone etiquette skills required
• Ability to work independently and as a team member
• Detail oriented and highly organized
• Ability to meet deadlines
• Must be able to work on multiple tasks/projects simultaneously
EDUCATION AND EXPERIENCE:
• High School Diploma or GED
• Background in a Healthcare claims/customer service