Medical Claims | Billing | Examiner (ON-SITE)

The Clearinghouse Support Rep is responsible for assisting customers with the resolution of product questions, including but not limited to: claims (denials and rejections); remittances such as missing remittance or incorrect setup; and account administration through customer portalResponsible for receiving, logging and responding to product application support questions from customers. The position requires written and verbal interaction with customers including insurance organizations, hospitals, physicians and nurses for the purpose of providing product usage or administrative solutionsCustomer contact points include but are not limited to telephone and email to log Service Requests which are answered via email and/or outbound calls, as needed. Payer contact may also be necessary at timesActivities include ownership of requests, research, analysis, escalation and customer communication necessary to deliver appropriate resolution to customer inquiriesCustomer Service: Receive, respond and log customer requests in accordance with department and company standards and procedures; Communicate critical customer status and issues to Support leadership as a given situation warrants; Maintain customer relationships and manage customer expectationsCase Management and Communication: Effectively log and manage all cases with attention to the documented service levels. document progress, and resolution of customer requests in issue tracking system in accordance with department and company standards and procedures; Adhere to escalation procedure and timeframesProduct knowledge: Review and analyze ANSI standard files such as but not limited to 837, 266, 277, 835, 270, and 271. Familiarize oneself with rejection and/or denial clearinghouse and payer codes to properly address related issuesTroubleshooting and Problem Solving: provide customers with application functional and administrative assistance within assigned product area of expertise; Drive to positive outcomes and customer experience; Effectively research and troubleshoot product functional issues within a defined area of expertise

Qualifications:

Graduate of any 4-year course or must have BPO / claims backgroundExperience using a CRM, Issue Management, or problem tracking application is an advantageProblem-solving skills and analytic ability.Positive and proactive customer service attitudeExcellent written and verbal communication skills to provide clear, concise, and correct product, technical, and status informationExcellent time management skill and organizational skills