Job Description

• The Clearinghouse Support Rep is responsible for assisting customers with the resolution of product questions, including but not limited to claims such as denials and rejections; remittances such as missing remit or incorrect setup; and account administration through the client portal.
• Responsible for receiving, logging and responding to product application support questions from customers
• The position requires extensive written and verbal interaction with customers including insurance organizations, hospitals, physicians and nurses for the purpose of providing product usage or administrative solutions.
• Customer contact points include but are not limited to telephone and email to log Service Requests which are answered via email and/or outbound calls, as needed. Payer contact may also be necessary at times.
• Activities include ownership of requests, research, analysis, escalation and customer communication necessary to deliver appropriate resolution to customer inquiries.
  

• Customer Service: Receive, respond and log customer requests in accordance with department and company standards and procedures; Communicate critical customer status and issues to Support leadership as a given situation warrants; Maintain customer relationships and manage customer expectations.
• Case Management and Communication: Effectively log and manage all cases with attention to the documented service levels. Document progress, and resolution of customer requests in issue tracking system in accordance to department and company standards and procedures
• Adhere to escalation procedure and timeframes.
• Product Knowledge: Review and analyze ANSI standard files such as but not limited to 837, 266, 277, 835, 270, and 271.
• Familiarize oneself with rejection and/or denial clearinghouse and payer codes to properly address related issues.
• Troubleshooting and Problem Solving: Provide customers with application functional and administrative assistance within assigned product area of expertise; Drive positive outcomes and customer experience; Effectively research and troubleshoot product functional issues within defined area of expertise.
  

• Bachelor’s degree or equivalent experience in US claims process
• Experience using a CRM, Issue Management, or problem tracking application
• Ability to diagnose, research and resolve issues independently
• Proven problem-solving skills and analytical ability
• Positive and proactive customer service attitude
• Excellent written and verbal communication skills to provide clear, concise and correct product, technical and status information

• Knowledge of HealthCare industries
• Knowledge of ANSI standard files
• Knowledge of HIPPA compliance regulations
• Knowledge of Payer/Provider environment