Call Center Representative-Remote TX Resident

The Customer Service Representative is responsible for handling patient and payer inquiries regarding medical billing, insurance claims, and account resolutions. This role ensures a positive patient's financial experience by providing timely, professional, and accurate responses to billing-related concerns. The Customer Service Representative works under the direction of the Revenue Cycle Manager Patient AR to support revenue cycle operations and enhance the efficiency of billing processes.

**Essential Duties and Responsibilities **

• Handle inbound and outbound calls regarding patient balances, insurance claims, and billing inquiries.

• Provide clear and empathetic explanations of charges, payment options, and account statuses.

• Assist patients with setting up payment plans and making payments.

• Research and resolve billing discrepancies, denials, and adjustments.

• Work with insurance carriers to verify claims status and escalate issues as

• Maintain a professional and courteous demeanor in all patient interactions.

• Ensure timely and effective resolution of patient and payer concerns.

• Document all customer interactions accurately in the system.

• Adhere to HIPAA guidelines and company policies regarding patient information security.

• Follow Fair Debt Collection Practices Act (FDCPA) guidelines when addressing outstanding balances.

• Work closely with the billing, collections, and revenue cycle teams to improve patient financial engagement.

• Provide feedback to management on recurring billing issues and recommend solutions.

• Participate in training and team meetings.

• Support special projects related to billing and collections.

Qualifications

**QUALIFICATIONS **

Education & Experience

• High school diploma or GED required.

• Minimum of 1 year of experience in healthcare customer service, billing, or insurance claims processing.

**Skills & Competencies **

• Excellent verbal and written communication skills.

• Basic knowledge of orthopedic-related coding, medical terminology, and insurance procedures preferred.

• Proficiency in Microsoft Office (Excel, Word, Outlook) and Athena software.

• Ability to handle high call volumes and work in a fast-paced environment.

• Strong problem-solving and conflict-resolution skills.

• High attention to detail and ability to follow workflows accurately.

**Work Environment & Physical Demands: **

• Standard office environment with prolonged periods of sitting and computer use.

• Occasional high-stress work requiring interaction with upset patients or insurance representatives.

• Manual dexterity required to operate a keyboard, calculator, and office equipment.