• Handle in-depth research regarding patient’s self-pay and insurance balances • Effectively explain policies and procedures • Refer accounts for resolution and provide feedback • Review and interpret Patient Statements • Obtain supporting documentation regarding Patient/Client follow-up efforts • Identify contractual and administrative adjustments • Assist and resolve patient inquiries/requests within 24-48 hours • Understand various insurance payer processes

• Analyze and monitor customer escalation reports to identify trends and update Knowledge Base tool. • Identify, manage and record escalation trends and communicate process issues, product defects and trends to Director, Support to drive continuous improvement. • Review, identify and analyze root cause for all escalated service requests; continuously improve based on analysis within delivery teams. • Focus on developing proactive solutions to avoid common issues within escalation process. • Provide guidance and support to Customer Support Specialists; serve as a go-to resource for complex escalations. • Own escalated cases received from various channels including: complaint review requests received from the customer, live HAC escalations, and negative NPS survey responses. • Execute review of member interactions, provide summary, and develop plan to resolve client issues including: identification of process errors, content gaps, misquotes, coaching opportunities, and associated action items such as service recovery, claims and benefits outreach to health plan, etc. • Act as a liaison to coordinate internal efforts cross-functionally through to issue resolution and completion of all related action items. • Draft external response and act as the point of contact for any follow up questions from the customer. • Ensure customer requests are responded to within agreed upon time frames and are resolved to customer and client satisfaction. • Use all key customer resolution tools across all service groups to facilitate resolution of customer concerns.

• Act as the primary point of contact for customer inquiries and internal support tickets from client-facing teams via email, recorded screenshares, live video calls, and internal channels • Handle complex, high-context customer issues that require investigation, explanation, and coordination across teams • Work directly with customers to troubleshoot setup, data health issues, and product-related questions • Identifies educational gaps in how customers understand the platform and works to close those gaps through documentation, product changes, improved onboarding, or better explanations • Collaborates closely with Customer Success, Product, and Engineering—working cross-functionally without needing deep backend expertise—and understands when to escalate technical or product-level issues with clear context and detailed reproduction steps • Proactively recommend and help implement improvements to support workflows, documentation, tooling, or handoff processes • Surface patterns in customer pain points and provide actionable feedback to Product and Engineering • This role will help shape how support operates and scales over time

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The remote Customer Service Specialist will be responsible for receiving and triaging all incoming patient and insurance calls, initiating outbound calls, and addressing questions and concerns regarding patient accounts through other platforms, as needed. You will be required to work in real time with a patient on the line. - Prior experience in working with difficult or upset customers and knowing how to manage escalation is necessary. - The primary responsibility for CSR’s is answering phones and returning voicemails to callers. - The secondary responsibility is to resolve written requests from an assigned worklist. - Research into multiple files and systems, as well as collaboration with several departments is necessary. - This takes critical thinking and a thorough working knowledge of Revenue Cycle Management (RCM) to handle requests effectively and efficiently. - This position has daily production benchmarks to help measure progress in meeting KPI’s. - This position requires strong interpersonal skills to interact professionally, promptly, and courteously with patients, internal teams, and surgery centers. - Collections experience is very helpful to work accounts and assist in resolving patient concerns. - Knowledge of how to interpret an Explanation of Benefits (EOB, RA, Remit) and how to read the PAS Ledger and notes is a must. - This position requires a high level of multi-tasking, technical ability, prioritization, time management, and organization. - Accessing multiple systems and applications is a requirement. - Prior A/R experience in a medical setting preferred. - May be assigned additional delegated responsibilities and special assignments by Central Billing Office Management. - Individuals should be flexible to perform a variety of duties. - Bilingual is preferred. Qualifications - Experience in customer service, particularly in handling difficult situations. - Strong interpersonal skills. - Knowledge of Revenue Cycle Management (RCM). - Ability to interpret EOBs and read PAS Ledgers. - Multi-tasking and organizational skills. - Technical proficiency in accessing multiple systems. - Prior A/R experience in a medical setting preferred. - Bilingual is preferred. Requirements - Handle a high volume of in-and-outbound phone calls to address various questions and concerns. - Research overdue account balances that are fully or partially unpaid and follow up by mail and/or phone to patients on delinquent payments. - Respond promptly to patient/internal team inquiries with clear communication and high-quality service. - Research customer accounts thoroughly and document appropriately. - Resolve discrepancies and prepare adjustments and refunds as necessary. - Collaborate with various departments within the Central Billing Office to resolve requests. - Ensure that all information regarding collection activity on accounts is entered accurately into the system. - Respond to written requests submitted electronically and ensure timely resolution. - Bring recurring issues to the attention of the department supervisors/manager. - Conduct duties with empathy, support, respect, and professionalism at the core of every interaction. - Evaluate and identify priority accounts. - Perform other duties as required.