Healthcare Customer Service Specialist

Argos Health has opportunities for qualified candidates available due to recent growth. We have several flexible 8-hour schedule options Monday - Friday, and options for a 4x10 schedule following training and based on meeting productivity requirements in a casual work environment every day! We have full medical/dental/vision benefits eligibility after 30 days, plus company-paid short-term & long-term disability and life insurance. PTO accruals begin day one of employment. 401k eligibility after 6 months with a great company match!

Position Summary:

Healthcare Customer Service Specialists are responsible for learning and understanding ERISA and the valuable aspects how we advocate for patients to ensure they receive all the benefits they are entitled to while managing a successful service for our clients. The Customer Service Specialists works in a fast-paced environment managing ‘mostly’ outbound calls to patients and subscribers seeking to obtain authorizations. You will be trained to obtain, analyze, and verify the accuracy of information received from the insurance companies and clients. Responsible for collecting Designation of Authorized Representative forms (DAR’s), health plan eligibility information, health plan cards, healthcare claims (UB04-HCFA 1500/837I-P), remittance advice (835), or explanation of benefits (EOB) from our clients HIS platform. You will work with an all-star team of appeals analyst who will leverage your work product and talents to proactively solicit assistance with plan administrators/sponsors, health plans, and other fiduciaries to ensure patients receive their benefits and our clients get paid what they should.

Key Responsibilities may include the following:

• Take and respond to a high volume of calls each day, providing required information to external agents and patients. Will manage required outbound calls to obtain the necessary information to support ERISA Appeals analysts with proper phone etiquette and timely response.
• Manage inbound requests (via workflow engine) from appeals analyst, provide appropriate documentation, and proactively manage patient communications until the DAR is obtained.

· Update patients’ records in predefined hospital or facility systems, ensuring that they are kept confidential and safe.

· Take and respond to a high volume of calls each day, providing required information to external agents and patients.

· Other duties as assigned

Qualifications:

Required– High School Graduate. Must have excellent customer service and phone skills. Ability to perform quality data entry, in high volume, with strong attention to detail, relatively error-free. MUST BE BILINGUAL (Spanish, English).

Highly Preferred– Hospital / Physician/ASC medical billing experience, health plan reimbursement methodologies, and/or coding experience.

Abilities/Skills- Computer literacy with word processing capabilities, Acrobat Pro and our database software and/or business systems (Word, Access, Excel, EPIC, Meditech, Cerner and other prevalent HIS software) as well as prevalent eligibility vendors Availity, Navinet and Optum familiarity. Strong oral, written communication skills; Active listening skills. Good analytical skills and highly detail-oriented.

Customer Focus- Is dedicated to meeting the expectations and requirements of internal and external customers; gets first-hand customer information and uses it for improvements in products and services; talks and acts with customers in mind; establishes and maintains effective relationships with customers and gains their trust and respect.

Team Player- Creates strong morale and spirit in his/her team; shares wins and successes; fosters open dialogue.

Self-confidence– A belief in one’s capability to accomplish a task and select an effective approach to a task or problem. This includes confidence in one’s ability as expressed in increasingly challenging circumstances and confidence in one’s decisions or opinions.

Argos Health is an equal opportunity employer. We are committed to providing equal employment opportunities without regard to race, creed, color, religion, national origin, sex, marital status, citizenship status, age, veteran status or disability.

Argos Health is an equal opportunity employer. We are committed to providing equal employment opportunities without regard to race, creed, color, religion, national origin, sex, marital status, citizenship status, age, veteran status or disability.

Job Type: Full-time

Pay: $15.00 - $16.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Customer Service: 1 year (Preferred)
• Healthcare Administration: 1 year (Preferred)
• Medical billing: 1 year (Preferred)

Language:

• Spanish (Required)

Work Location: One location