1+ months

HCS Customer Service Specialist II (SCA)

San Angelo, TX 76903
Regular Full Time

***NOTE COVID-19***: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company. 

Customer Service Specialists II (SCA)'s
 are the primary points of contact for all providers, Medicare contractors, etc. They respond to all inquiries and provide supporting documentation. In addition, they conduct improper claims payment recovery efforts.

Essential duties:

Facilitate and process requests from and/or to the Performant Team
Make necessary contacts and/or perform necessary research to validate provider contact information
Contact healthcare providers on overpaid claims and maintain collection records and account status updates
Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors
Establish good contact with providers to guarantee proper claim presentation and follow up
Enter and update all contact and activity information into MARS where not automatically completed by the system, e.g., a telephone call is made, recorded, and attached to the case file in MARS, but the outcome must be extracted from the call and input into MARS
Notify management of:  
     all correspondence indicating displeasure with the RAC, in the overpayment identification, or in the recovery methods utilized, 
     legal action 
     government intervention
    escalated concerns regarding audit issues and edit parameters 
     suggestions to improve or correct processes or documents

Research and route internal/external communications to the appropriate person or department, including referrals received from Medicare contractors and documents, calls, and faxes sent to Medicare contractors by mistake
Conduct critical due diligence follow-ups of unread media
Answers questions from providers and resolves issues via phone and written correspondence
Educating providers on their appeal rights
Communicate with other staff/departments as necessary
Maintain a current knowledge of all Medicare rules, regulations, policies and procedures
Maintain current knowledge of all contract requirements and objectives
Maintain HIPAA Certification
Conduct simple coding reviews
Perform miscellaneous duties as assigned in a highly professional manner
Required Skills and Knowledge:

Thorough working knowledge of CPT/HCPCs/ICD-9 coding
Excellent verbal and written communication skills
Skilled in data entry and knowledge of computers
Courteous, professional, and respectful attitude
Strong understanding of customer service policies and processes
Provider customer service background
Basic understanding of accounts payable and receivable
Possess knowledge of CMS rules and regulations
Claims processing and/or billing experience
Proficient in the use of HCFA/UB forms
Flexibility to handle any non-standard situations that may arise
Must be able to multi task
Sit/stand/ walk 8-10 hours/day
Lift/carry/push/pull under and over 10lbs occasionally
Keying frequency, handling, reaching, fine manipulation
Education and Experience:

4+ years Medical claims processing, and/or medical customer service
2+ years claims billing
Hospital billing experience preferred
High School diploma or equivalent

Other Requirements:

-Must submit to and pass background check. 
-Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors.
-Must submit to and pass drug screen.

Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Job Profile is subject to change at any time.

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

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Posted: 2021-04-08 Expires: 2021-06-10

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HCS Customer Service Specialist II (SCA)

Performant Financial
San Angelo, TX 76903

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