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Customer Services Representative
Center for Health Care Strategies. Answer incoming calls from guarantors and insurance companies in a high-pressure call center .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in insurance verification, account maintenance, and customer service within a high-pressure call center environment. Proficient in resolving issues for guarantors and insurance companies while maintaining accurate records and compliance with healthcare standards.
Highest-signal resume keywords
Insurance KnowledgeAccount MaintenanceCustomer ServiceHealthcare ExperiencePayment Processing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Insurance VerificationAccount MaintenancePayment ProcessingIssue ResolutionData Entry
Soft Skills
CommunicationProblem-SolvingAttention to DetailTime Management
Tools & Technologies
Online Payment PortalComputer-Based Training Systems
Industry Keywords
HealthcareInsurance PayorsCommercial InsuranceGovernment InsuranceHMO/PPOIndemnity Insurance
About the role
Key responsibilities & impact- Answer incoming calls from guarantors and insurance companies in a high-pressure call center
- Research and resolve issues for guarantors, insurance companies and internal customers
- Perform account maintenance, verify demographics, update guarantor information, and fulfill customer or insurance company requests
- Verify and process insurance coverage information, perform insurance adjustments, and change insurance filing order as needed
- Review and analyze credit or debit balances to determine whether additional payment is owed or a refund is due
- Establish payment plans, set up recurring payments, and transfer guarantor funds to clear outstanding balances
- Troubleshoot issues with the online payment portal for guarantors
- Escalate unresolved issues as appropriate
- Perform annual required system upgrades and computer-based training
Requirements
What you’ll need- High School Diploma
- 1-3 years healthcare experience preferred
- Strong insurance knowledge and medical office background preferred
- Thorough knowledge of insurance payors (Commercial, Government, HMO/PPO and Indemnity) preferred