Job Title

Overview Position Highlights : Full-Time, 40 Hours Hours: Monday-Friday 8:30-5:00pm Location: WFH after first 90 days in office. Travel: None Benefits: Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider. Employer provided life and disability insurance. $5,250 Tuition Reimbursement per year. Immediate 401(k) match. 40 hours paid volunteer time off. A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact. 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members. Responsibilities The Customer Service Representative works in a call center environment, handling incoming calls from patients, vendors, health plans, and clinic employees. They are responsible for handling questions regarding billing, collections, referrals, payment arrangements, and an array of other financial related questions. A Customer Service Representative is responsible for outbound calling, message response, and interdepartmental communications. Provides exemplary Customer Service to patients, providers and employees for Duly Health and Care Answers patient questions, inquires, and concerns regarding their accounts. Works with patients and providers to resolve account challenges and communicate appropriate next steps for troubleshooting Identifies potential revenue cycle challenges and escalates to departmental and/or leadership review as necessary Identifies insurance errors and is responsible for updating and loading insurance or identifying the appropriate parties to take the next needed action Responds to voice mail messages, My Chart Inquires, requests from Duly Health and Care Website and Patient Correspondence within 48 hours. Responds to client relation management messages and MyChart communication within a specified turnaround time Provides capitated medical claim status to contracted providers. Provides Referral and Authorization Status to patients and providers for capitated and non-capitated plans. Reviews billing transactions for accuracy and to help resolve payment posting challenges on accounts Liaises with Utilization Management to assist with appropriate resolution of authorization challenges, timelines, and execution Reviews insurance portal benefit information for appropriate communication with patients and clients Providers capitated claim status to contracted providers and discussion of capitation procedures Works with patients to resolve account balance by taking payments, setting up payment plans or screening for Financial Hardship when appropriate. Qualifications Level of Education High school diploma or GED Years of Experience 2-5 years experience in membership, customer service, and/or healthcare billing