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Customer Service Representative

Job Description

The Claims Recovery Services Team is a responsible for making outbound calls and addresses inbound calls. The reps work directly with health care providers to coordinate recovery / collection of overpayments. The team reviews overpayment situations, resolve, and recover dollars for health plans, commercial customers, and government entities. This position handles overpaid claim inventory through telephone contact with the provider, which includes physician, facility, labs, etc. 

Reps will have daily/weekly/monthly goals to maintain. The reps will be taking inbound calls and outbound calls 

Specific Duties: 
1.Take inbound calls from providers and/or make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones) 
2 With a focus on building a strong working rapport with the provider representatives to review and discuss overpayment situations and provide detailed explanations to the providers in both verbal and written format 
3. Escalate recovery efforts through many avenues to progress and resolve the situations 
4. Strive to meet and exceed quality production defined goals (calls/contacts), including a financial target 
5. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance 
6. Complete required documentation on all recovery efforts on a timely basis in the appropriate claims platforms 
7. Perform other duties as assigned 

Job Requirements

Must have qualifications/experience: 
1.High school diploma or GED (or higher) or equivalent work experience 
2. 1+ Medical Claims, Professional Billing, and / or Collections 
3. 1+ year of experience analyzing and solving customer problems 

Shift Start/End Time: it will depend on the region we need them to work, they could work anywhere between 8-7pm EST 

Dress Code: Casual

Job Snapshot

Location US-MD-Frederick
Employment Type Full-Time Employee
Pay Type Year
Pay Rate N/A
Store Type Customer Service
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Company Overview

Equity Staffing Group

Equity Staffing Group provides innovative workforce solutions to help clients operate more efficiently and more successfully. We provide staffing services to organizations and career opportunities for job seekers in the following disciplines: Information Technology, Professional Services, Finance & Accounting, Healthcare, Legal, Engineering and Light Industrial. Equity Staffing Group is a certified Minority-Owned and Operated (MBE) Consulting, Contingent Labor and Payroll Solutions provider focused on providing strategic solutions for Global 1000 corporations. We are owned and operated by a member of the Potawatomi Nation. Equity is one of the largest and fastest growing Native American owned and operated staffing agencies in the world. Equity Staffing Group provides local expertise backed by national resources and a network of professionals. We are always at work identifying, recruiting, and developing relationships with talented professionals across the country. Learn More

Contact Information

US-MD-Frederick
Kristy Frazier
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Snapshot
Equity Staffing Group
Company:
US-MD-Frederick
Location:
Full-Time Employee
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Customer Service
Store Type:

Job Description

The Claims Recovery Services Team is a responsible for making outbound calls and addresses inbound calls. The reps work directly with health care providers to coordinate recovery / collection of overpayments. The team reviews overpayment situations, resolve, and recover dollars for health plans, commercial customers, and government entities. This position handles overpaid claim inventory through telephone contact with the provider, which includes physician, facility, labs, etc. 

Reps will have daily/weekly/monthly goals to maintain. The reps will be taking inbound calls and outbound calls 

Specific Duties: 
1.Take inbound calls from providers and/or make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones) 
2 With a focus on building a strong working rapport with the provider representatives to review and discuss overpayment situations and provide detailed explanations to the providers in both verbal and written format 
3. Escalate recovery efforts through many avenues to progress and resolve the situations 
4. Strive to meet and exceed quality production defined goals (calls/contacts), including a financial target 
5. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance 
6. Complete required documentation on all recovery efforts on a timely basis in the appropriate claims platforms 
7. Perform other duties as assigned 

Job Requirements

Must have qualifications/experience: 
1.High school diploma or GED (or higher) or equivalent work experience 
2. 1+ Medical Claims, Professional Billing, and / or Collections 
3. 1+ year of experience analyzing and solving customer problems 

Shift Start/End Time: it will depend on the region we need them to work, they could work anywhere between 8-7pm EST 

Dress Code: Casual

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Customer Service Representative Apply now