Customer Service Specialist II – HCS

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🕒 June 30

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Logo of Performant Healthcare, Inc.

Performant Healthcare, Inc.

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Performant Healthcare, Inc. is a U. S. -based, technology-enabled payment integrity and recovery company that helps health plans and government payers identify improper payments, recoup funds, and reduce waste. Performant combines data analytics, audit expertise, and recovery/collections infrastructure to deliver services including inpatient and outpatient audits, post-acute/home care audits, third-party liability (TPL) identification, Medicare Secondary Payer (MSP) outreach, lockbox and OCR document processing, and end-to-end recovery management. The company emphasizes scalable, customizable solutions (Audit Advantage, Data Mining Advantage, MSP Advantage, TPL Advantage, Recovery Advantage) to control costs and improve payment accuracy for managed care organizations and government agencies, backed by more than 40 years of recovery experience.

📋 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. • Provide professional, accurate and timely responses to CMS (Medicare) and provider inquiries. • 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.

🎯 Requirements

• At least two (2) years’ experience in a call center or customer service position required • At least one (1) year claims processing/billing experience preferred • High School diploma or GED is required • Must maintain HIPAA Certification • Strong understanding of customer service policies and processes • Excellent verbal and written communication skills • Skilled in data entry and knowledge of computers • Working knowledge of Excel • Courteous, professional, and respectful attitude • 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, HSA/FSA options • life insurance coverage • 401(k) savings plans • family/parental leave • paid holidays • paid time off annually

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