Healthcare Customer Service Specialist II @Performant Recovery, Inc.

[Hiring] Healthcare Customer Service Specialist II @Performant Recovery, Inc.

Mar 25, 2025 - Performant Recovery, Inc. is hiring a remote Healthcare Customer Service Specialist II. đź’¸ Salary: $18.41/hour. đź“ŤLocation: USA.

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Role Description

As a Healthcare Customer Service Specialist II (SCA) you will work within a team and be the primary point of contact for all providers, Medicare contractors, etc. This position provides professional, accurate and timely responses to CMS (Medicare) and provider inquiries. This includes responding to written, telephonic, and electronic inquiries within the appropriate timeframes.

  • Maintain a current knowledge of all contract requirements and objectives.
  • Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors.
  • Take inbound calls from providers to answer questions and resolve complex issues.
  • Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received.
  • Respond to assigned written communications from providers timely and accurately.
  • Educate providers on proper process protocols and their appeal rights.
  • Establish appropriate contacts and perform necessary research to validate provider contact information.
  • Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry.
  • Enter and update all contact and activity information into tracking logs and the audit platform where not automatically completed by the system.
  • Research and route internal/external communications to the appropriate person or department.
  • Notify management of escalated displeasure with the audit program, legal action, government intervention, escalated concerns regarding audit issues and edit parameters, and suggestions to improve or correct processes or documents.
  • Perform miscellaneous duties as assigned in a highly professional manner.

Qualifications

  • At least two years’ experience in a call center or customer service position required.
  • At least one year claims processing/billing experience preferred.
  • High School diploma or GED is required.
  • Must maintain HIPAA Certification.

Requirements

  • Excellent verbal and written communication skills.
  • Skilled in data entry and knowledge of computers.
  • Working knowledge of Excel.
  • Courteous, professional, and respectful attitude.
  • Strong understanding of customer service policies and processes.
  • Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program.
  • Healthcare and insurance terminology knowledge preferred but not required.
  • Flexibility to prioritize and handle non-standard situations that may arise.
  • Must be detailed, organized and able to manage various job duties as required.
  • Maintain a strong work ethic and attendance.

Benefits

  • Medical, dental, vision, disability coverage options.
  • Life insurance coverage.
  • 401(k) savings plans.
  • Paid family/parental leave.
  • 11 paid holidays per year.
  • Sick time and vacation time off annually.

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Healthcare Customer Service Specialist II @Performant Recovery, Inc.
Customer Service
Salary đź’¸ $18.41/hour
Remote Location
USA
Job Type full-time
Posted Mar 25, 2025
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đź“Ť Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
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