Job Description

Our Ideal Candidate

We are looking for a dedicated, customer-focused individual to join our Shield team, a specialized department committed to providing exceptional support. In this role, you will communicate directly with medical providers, customers, and members of group health plans via email, facsimile, and telephone. Your ability to problem-solve, communicate effectively, and manage customer expectations will be key to your success. If you are passionate about helping others and thrive in a dynamic, fast-paced environment, this position is for you. This role reports directly to the Customer Service & Shield Manager.

Responsibilities

• Work with customers and medical providers, checking the status of medical bills, responding to specific billing inquiries, and addressing healthcare-related questions.
• Review client requirements for each Shield-eligible claim(s)/bill(s) and complete necessary follow-up.
• Answer incoming customer calls regarding billing issues, product problems, service questions and general client concerns.
• Interpret policies and procedures and exercise effective communication.
• Work with the Bill Review leadership team to stay updated on product knowledge and be informed on any client-related workflow changes and company policies.
• Provide internal team and client with detailed call log on cases and client inquiries.
• Document medical provider and client-related inquiries in the bill review system and ShareFile.
• Maintain and triage Medical Provider Inquiry email boxes and other duties as required.
• Assist with obtaining necessary documentation from the client, patient, health care member, or medical provider and uploading documentation into the WellRithms system.

Qualifications

• A high school diploma is required, with some college education preferred.
• 2+ years of experience in customer service or a healthcare-related field.
• Knowledge of medical terminology, CPT Codes, and DRG billing codes preferred.
• Strong organizational, oral, written, and interpersonal skills, including courteous telephone etiquette.
• High comfort level with computers and computer programs (MS Word, MS Excel, MS Outlook).
• Ability to set priorities and work independently as well as in a team environment.
• Ability to meet deadlines in a time-sensitive environment.

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