Customer Service Specialist

March 6

🌴 South Carolina – Remote

Although this job is listed in South Carolina, this company may be open to hiring remote in other states.

⏰ Full Time

🟢 Junior

🟡 Mid-level

💝 Customer Support

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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Prisma Health

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Prisma Health is a comprehensive health care provider offering a wide range of medical services to ensure individuals achieve their healthiest state. With numerous locations, advanced technology, and expert specialists, Prisma Health provides accessible and convenient care. Services include primary care, specialized heart, cancer, women's, and children's health, as well as same-day and telehealth options. Prisma Health emphasizes community outreach and education to support overall health and wellness.

10,000+ employees

⚕️ Healthcare Insurance

📋 Description

• Performs tasks of moderate to difficult complexity relating to both hospital and physician accounts. • Handles a large volume of inbound calls. • Responsible for also making outbound calls related to self-pay follow up on accounts. • Assists patients with requests for information, complaints, and resolving issues. • Responsible for data analysis and interpretation throughout all functions of revenue cycle, to determine reasons for denials, non-payment and overpayment. • Post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts. • Analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances and analysis/movement of unapplied, unidentified, undistributed balances. • Moderate to difficult levels of evaluation, analysis, decision making required in these roles. • Resolves billing concerns, addresses inquiries related to insurance concerns/matters, assist patients with MyChart. • Reviews accounts to determine insurance coverage; obtains and corrects any missing or inaccurate information. • Discusses patient responsibility, which includes educating patients on claim processing, deductible, coinsurance, and co-pays. • Interacts with patients by making patients aware of payment options such as payment plans and financial assistance. • Ability to set up payment plans in MyChart based on patient's personal needs. • Greets patients in a professional and courteous manner. • Communicates clearly and professionally in both oral and written communication. • Maintains a high level of poise and professionalism in dealing with patients. • Research customer requests or issues, determines if further action is needed, forwards to appropriate party for resolution. • Contacts payer and makes hard inquiries on account status if needed. • Escalates problem accounts to the appropriate area(s). • Documents billing activity on a patient's accounts according to departmental guidelines. • Ensures all work is compliant with privacy, HIPAA, and regulatory requirements. • Participates in general or special assignments and attends all required training. • Knowledgeable of the job functions required for various representative roles required by Prisma Health. • Answers all incoming calls from Prisma Health patients for both the Columbia and Greenville markets. • Performs other duties as assigned.

🎯 Requirements

• Education - High School diploma or equivalent OR post-high school diploma / highest degree earned • Experience - 2 years - Billing, bookkeeping, accounting