Client Support Representative

About the role

The Client Support Representative position is responsible for providing service excellence through accurate case entry and client communication. Other responsibilities include timely and accurate data entry, scheduling of peer-to-peer reviews and communication with client representatives and payors as necessary.

Responsibilities

• Timely and accurate data entry
• Scheduling of payor calls and peer-to-peer discussions
• Accurate assignment of case numbers to avoid duplicate entries
• Notifying management of any duplicate accounts or areas needing clarification
• Accurate entry of return on investment information including case outcomes and payor recoupment information
• Entering, following, and exporting denials/appeals cases in line with client SLA/needs
• Processing cases according to workflow needs and established productivity standards
• Providing follow-up information to clients and ancillary departments as necessary
• Forwarding relevant documents to necessary parties as needed

Requirements

• Exemplary customer service to clients, payors, and team members
• Accurate chart entry and completion
• Searches account numbers for each case entry and accurately assigns case number to avoid duplicate entry
• Performs scheduling of payor calls and peer-to-peer discussions, including physician calendar management and follow up
• Accurately enters return on investment information including case outcomes and payor recoupment information
• Inputs, follows, and exports denials/appeals cases in line with client SLA/needs including accurate data entry of payor information including but not limited to insurance plans, denied amounts and denied codes/DRGs
• Processes cases according to workflow needs and established productivity standards
• Works with clients and ancillary departments, providing follow up information when necessary and/or forwarding relevant documents to necessary parties
• Performs other duties as assigned

Knowledge, Skills and Abilities

• Proficient in Outlook email, calendar and case management systems
• Computer Skills - Demonstrates proficiency in Microsoft Office applications and others (O365, MS Word, Excel, PowerPoint)
• Strong communication skills - Communicates clearly and concisely, verbally and in writing
• Strong office skills such as fax, scan, phone
• Client orientation: Establishes and maintains long-term client relationships, building trust and respect by consistently meeting and exceeding expectations
• Policies & Procedures: Demonstrates knowledge and understanding of organizational policies, procedures and systems
• Interpersonal skills - Able to work effectively with employees and clients (internal/external)
• Basic skills: Demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, has ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately. Ability to work independently, needing minimal supervision

Work Experience, Education and Certifications

List preferred/required work experience, education, and certifications. High school diploma or GED required. Payor knowledge and denials management experience preferred but not necessary

Working Conditions and Physical Requirements

• Conditions typically associated with an office environment
• While performing the essential duties and responsibilities, the employee is regularly required to talk or hear
• May be frequently required to sit, stand or walk
• Moderate to prolonged reading, typing, and computer work
• Ability to perform tasks involving physical activity that may include lifting up to 25 pounds
• Subject to exposure to all environmental hazards associated with healthcare and office work
• Limited Travel required (10%)