Medical Customer Service in Frisco, TX at Pionear

Date Posted: 6/24/2019

Job Snapshot

Job Description

Job Description

Customer Service Medical Specialist

Pionear Recruiting has a great career opportunity for you as a Benefits Verification Specialist in the Frisco Area. Y

Under general supervision of an Operations Manager, the Customer Service Medical Ambassador  will contact insurance companies to verify patient specific benefits for programs we administer. The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage. 

1. Reviews all patient insurance information needed to complete the benefit verification process. 
2. Triages cases with missing information to appropriate program associate. 
3. Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options. 
4. Identifies any restrictions and details on how to expedite patient access. 
5. Could include documenting and initiating prior authorization process, claims appeals, etc. 
6. Completes quality review of work as part of finalizing product. 
7. Reports any reimbursement trends/delays to management. 
8. Performs related duties and special projects as assigned.

Job Requirements


Job Requirements

Customer Service Medical Specialist Job Description

1. Proficient Windows based experience including fundamentals of data entry/typing 
2. Working knowledge of Outlook, Word, and Excel 
3. Strong interpersonal skills and professionalism 
4. Independent problem solver, good decision maker, and robust analytical skills 
5. Strong attention to detail 
6. Effective written and verbal communication 
7. Familiarity with verification of insurance benefits preferred 
8. Attention to detail, flexibility, and the ability to adapt to changing work situations. 
9. Strong customer service experience 

High school diploma or GED required. Requires broad training in fields such as business administration, accounting, computer sciences, medical billing and coding, customer service or similar vocations generally obtained through completion of a two-year associate’s degree program, technical vocational training, or equivalent combination of experience and education. Two years (2) + years directly related and progressively responsible experience required. A two-year degree can be used in lieu of 2 years of the experience requirement.