Patient Services Specialist II

Job Description Summary

ModMed is hiring a Patient Claim Specialist to support patients receiving care from ModMed BOOST service providers and doctors. This role involves handling patient balance inquiries, claims processing, insurance updates, and payment collections. The ideal candidate will also initiate outbound calls to address account/payment issues and manage 60+ inbound calls per day.

About the role

ModMed is a fast-growing healthcare IT company that modernizes medicine through its AI-enabled, specialty-specific cloud platform. The Patient Claim Specialist plays a crucial part in enhancing the patient experience and supporting the revenue cycle management team.

Responsibilities

• Serve as the primary contact for all inbound and outbound patient calls regarding patient balance inquiries, claims processing, insurance updates, and payment collections.
• Initiate outbound calls to patients of RCM clients to understand and address any account/payment issues, such as demographic and insurance updates.
• Input and update patient account information and document calls into the Practice Management system.
• Other duties as required to support and enhance our customer/patient-facing activities.

Requirements

• High School Diploma or GED required.
• Availability to work 9 am to 6 pm EST.
• Minimum of 1-2 years of previous healthcare administration or related experience required.
• Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs).
• Manage/field 60+ inbound calls per day.
• Bilingual is preferred.
• Proficient knowledge of business software applications such as Excel, Word, and PowerPoint.
• Strong communication and interpersonal skills with an emphasis on effective telephone communication.
• Ability and openness to learn new things.
• Ability to work effectively within a team in order to create a positive environment.
• Ability to remain calm in a demanding call center environment.
• Professional demeanor required.
• Able to effectively manage time and competing priorities.

Skills

• High School Diploma or GED required.
• Basic understanding of medical billing claims submission process and working with insurance carriers required (e.g., Medicare, private HMOs, PPOs).
• Manage/field 60+ inbound calls per day.
• Bilingual is preferred.
• Proficient knowledge of business software applications such as Excel, Word, and PowerPoint.
• Strong communication and interpersonal skills with an emphasis on effective telephone communication.
• Ability and openness to learn new things.
• Ability to work effectively within a team in order to create a positive environment.
• Ability to remain calm in a demanding call center environment.
• Professional demeanor required.
• Able to effectively manage time and competing priorities.

Benefits

• United States Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution.
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
• Generous Paid Time Off and Paid Parental Leave programs.
• Company paid Life and Disability benefits.
• Flexible Spending Account.
• Employee Assistance Programs.
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed.
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning.
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles.
• Weekly catered breakfast and lunch.
• Treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.