Customer Service Representative (Bilingual - Spanish Preferred)

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GENERAL JOB DESCRIPTION
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 financial experience by providing timely, professional, and accurate responses to billing-related concerns. The Customer Service Representative works under the direction of the Customer Service & Collections Manager to support revenue cycle operations and enhance the efficiency of billing processes.
Bilingual - Spanish-speaking
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
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.
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Location:
Texas City, TX, United States
Category:
Office And Administrative Support Occupations

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