POSITION SUMMARY:

The Client Service Representative assumes a pivotal role in the organization by managing patient/client files, ensuring meticulous documentation arrangement, and navigating various systems efficiently. This role demands a keen eye for quality review and the ability to decipher diverse documents such as EOBs, AOBs, patient ledgers, PIP logs, and legal documentation. An in-depth understanding of Auto Carriers, Health Insurance, and Third-Party Administrators (TPAs) is essential, along with the ability to differentiate between policy numbers and claim numbers while strictly adhering to privacy and security protocols for protected health information. An ideal candidate for the position will have prior experience in medical billing, which enriches their skill set for effectively handling the responsibilities outlined in the job description.

PRIMARY DUTIES & RESPONSIBILITIES:

• Adeptly scan, upload, and arrange various documents with speed and accuracy.
• Efficiently maneuver through diverse medical billing systems necessary for accessing patient files.
• Conduct thorough quality reviews to ensure the accuracy and completeness of all documents.
• Identify various documents, including EOBs (explanation of benefits), AOBs (assignment of benefits), patient ledgers, PIP logs, and some legal paperwork.
• Demonstrate the ability to identify Auto Carriers, Health Insurance, and Third-Party Administrators (TPAs), and understand their roles and processes.
• Understand the significance of policy and claim numbers throughout the audit process.
• Proactively identify and resolve issues following established protocols.
• Maintain the confidentiality and security of protected health information in compliance with HIPAA regulations.
• Provide exceptional customer service to clients, addressing inquiries and concerns promptly and professionally.
• Collaborate effectively with internal teams to ensure smooth communication and resolution of issues.
• Document and escalate complex cases or discrepancies according to established protocols.
• Participate in ongoing training and professional development opportunities to stay updated on industry trends and best practices.
• Assist in the development and implementation of process improvements to enhance efficiency and quality of service delivery.
• Maintain employee activity production tracking to monitor and assess individual performance levels.
• Continuously maintain and update client information as required to ensure accuracy and relevance.
• Support other administrative tasks and projects as assigned by management to meet organizational needs and priorities.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Medical Billing experience with high-level Customer Service Experience
• Scanning Documents
• Some knowledge of the medical field and terminology (worked in a doctor’s office – Medical Assistant that has worked in the front and back office)
• Familiar with CMS 1500 – HICA Healthcare Insurance Claim Form
• Perform additional duties as assigned.

QUALIFICATIONS:

• High School diploma, required. 2 years of college, preferred.
• Excellent communication, customer service, interpersonal, organizational, decision-making, relationship building and negotiation skills.
• Ability to handle confidential information and abide by HIPAA laws and other medical policies.
• Proficiency in CRM software and Microsoft Office Suite (MS Office - Word, Excel, PowerPoint and Outlook).
• Requires 80% travel to various clients in different counties, regions of Massachusetts

PHYSICAL DEMANDS

Prolonged periods of standing or sitting at a desk while working on a computer interacting with clients. Lifting or carrying documents or equipment, such as scanners or a laptop, occasionally. Must be able to lift up to 15 pounds at times. Using hands or fingers to operate office equipment, type, or handle paperwork. Communicating verbally with clients and colleagues in person or over the phone for extended periods. Occasionally bending, stooping, or reaching to access files or office supplies. Maintaining focus and concentration for extended periods while performing detailed tasks. These physical demands may vary depending on the specific requirements of the job.

Job Type: Full-time

Schedule: Monday to Friday

Location: New Bedford, MA – Worcester, MA – Framingham, MA

Top Reasons to Work for Us!

Ged Lawyers provides a wide range of benefits including: medical, vision and dental insurance, life insurance, short and long-term disability, 401K matching plan, holidays and paid time off.

Staffing Agencies: Unsolicited resumes from search firms will not be honored as valid. Consequently, we politely ask agencies not to solicit our business managers directly as well. Thank you in advance.

EOE/M/F/D/V

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: On the road