St. Luke's Cataract & Laser Institute
Customer Solutions Representative
St. Luke's Cataract & Laser Institute, Indianapolis, Indiana, us, 46262
Position: Customer Solutions Representative
Location:
Tarpon Springs, FL
Job Id: 597
# of Openings: 1
Customer Solutions Representative St. Luke's Cataract & Laser Institute is looking to hire a full-time Customer Solutions Representative to join our team at our Tarpon Springs location.
About the Position The Customer Solutions Representative reporting to the Revenue Cycle Manager is responsible for taking inbound calls to answer patient’s question about their medical bills. The ideal candidate will be comfortable in working in a team environment and has a strong customer service focus to effectively interact with patients, doctors, staff and management.
Responsibilities
Respond to inbound calls, emails, and messages from patients, insurance carriers, and providers regarding insurance billing and claim issues
Provide clear and accurate information regarding claim status, benefit coverage, balances, co-pays, deductibles, and authorization requirements
Resolve or escalate customer concerns involving insurance denials, coordination of benefits (COB), and payment disputes
Investigate account balances by reviewing EOBs, remittance advices, claim notes, and insurance policies
Contact insurance carriers as needed to verify claim receipt, payment status, or denial reasons
Work with internal billing and coding staff to resolve discrepancies and ensure appropriate follow-up on claims
Document all customer interactions and actions taken within the billing system or CRM
Track open issues and ensure timely follow-up and closure of outstanding inquiries
Assist in preparing letters or forms required for appeals, corrected claims, or additional documentation requests
Educate patients on insurance terminology, claim processes, and their financial responsibilities
Explain payment options, including setting up payment plans or connecting them with financial counseling services
Help patients understand coordination of benefits, prior authorization requirements, and out-of-network implications
What do we kook for?
Solid understanding of medical insurance including deductibles, copay and coinsurance is highly preferred
Experience with verifying and interrupting medical benefits for Medicare, Medicaid and major commercial health insurance and secondary payers required
Experience processing provider referrals and prior authorization requests
Understanding of medical terminology and ICD-10 codes and Diagnosis
Familiar with individual payer guidelines and authorization/referral requirements based on insurance plans and if needed communicate with insurance companies via phone and/or website to provide any supporting clinical documentation needed to complete the authorization process
Ensure complete and accurate information maintained in patient account including authorization or referral received from payer or Primary Care Physician
Strong people skills required; diplomatic, patient, flexible and able to multi-task and be cross trained on all functions within the Insurance Verification Department
Must be mobile in an office setting, sitting, standing, walking, and bending
Perform general duties and other functions as required or assigned
Working knowledge of Microsoft Suite including Excel, Word, Outlook
Company Mission “Life Changing Vision” is a mission statement we adhere to in every aspect of our caregiving, from the moment a patient walks through our doors to the follow-up care they receive. We are committed to helping our patients attain overall wellness in body, mind, and spirit.
Why work at St. Luke’s? St. Luke’s is a legendary ophthalmic practice with five locations in the Gulf Coast region of Florida and two in The Villages. The St. Luke’s name is known not only for excellence in cataract surgery results and patient care but also for career opportunities and growth in the communities we serve.
The Benefits of working for St. Luke’s
Opportunity to build a career with a longstanding, reputable organization
Medical, Dental, Vision, Life Insurance, 401(k) with Employer Match, Paid Time Off, and Holiday Pay
The chance to work with and learn from excellent doctors and staff
We are an Equal Opportunity Employer and a Smoke & Drug Free Workplace
#J-18808-Ljbffr
Location:
Tarpon Springs, FL
Job Id: 597
# of Openings: 1
Customer Solutions Representative St. Luke's Cataract & Laser Institute is looking to hire a full-time Customer Solutions Representative to join our team at our Tarpon Springs location.
About the Position The Customer Solutions Representative reporting to the Revenue Cycle Manager is responsible for taking inbound calls to answer patient’s question about their medical bills. The ideal candidate will be comfortable in working in a team environment and has a strong customer service focus to effectively interact with patients, doctors, staff and management.
Responsibilities
Respond to inbound calls, emails, and messages from patients, insurance carriers, and providers regarding insurance billing and claim issues
Provide clear and accurate information regarding claim status, benefit coverage, balances, co-pays, deductibles, and authorization requirements
Resolve or escalate customer concerns involving insurance denials, coordination of benefits (COB), and payment disputes
Investigate account balances by reviewing EOBs, remittance advices, claim notes, and insurance policies
Contact insurance carriers as needed to verify claim receipt, payment status, or denial reasons
Work with internal billing and coding staff to resolve discrepancies and ensure appropriate follow-up on claims
Document all customer interactions and actions taken within the billing system or CRM
Track open issues and ensure timely follow-up and closure of outstanding inquiries
Assist in preparing letters or forms required for appeals, corrected claims, or additional documentation requests
Educate patients on insurance terminology, claim processes, and their financial responsibilities
Explain payment options, including setting up payment plans or connecting them with financial counseling services
Help patients understand coordination of benefits, prior authorization requirements, and out-of-network implications
What do we kook for?
Solid understanding of medical insurance including deductibles, copay and coinsurance is highly preferred
Experience with verifying and interrupting medical benefits for Medicare, Medicaid and major commercial health insurance and secondary payers required
Experience processing provider referrals and prior authorization requests
Understanding of medical terminology and ICD-10 codes and Diagnosis
Familiar with individual payer guidelines and authorization/referral requirements based on insurance plans and if needed communicate with insurance companies via phone and/or website to provide any supporting clinical documentation needed to complete the authorization process
Ensure complete and accurate information maintained in patient account including authorization or referral received from payer or Primary Care Physician
Strong people skills required; diplomatic, patient, flexible and able to multi-task and be cross trained on all functions within the Insurance Verification Department
Must be mobile in an office setting, sitting, standing, walking, and bending
Perform general duties and other functions as required or assigned
Working knowledge of Microsoft Suite including Excel, Word, Outlook
Company Mission “Life Changing Vision” is a mission statement we adhere to in every aspect of our caregiving, from the moment a patient walks through our doors to the follow-up care they receive. We are committed to helping our patients attain overall wellness in body, mind, and spirit.
Why work at St. Luke’s? St. Luke’s is a legendary ophthalmic practice with five locations in the Gulf Coast region of Florida and two in The Villages. The St. Luke’s name is known not only for excellence in cataract surgery results and patient care but also for career opportunities and growth in the communities we serve.
The Benefits of working for St. Luke’s
Opportunity to build a career with a longstanding, reputable organization
Medical, Dental, Vision, Life Insurance, 401(k) with Employer Match, Paid Time Off, and Holiday Pay
The chance to work with and learn from excellent doctors and staff
We are an Equal Opportunity Employer and a Smoke & Drug Free Workplace
#J-18808-Ljbffr