Customer Service Representative (Medical Billing)

Gryphon-Healthcare; Houston (TX); On-site; USD 36,000 - 48,000; Full time

Job summary

Gryphon-Healthcare is seeking a Customer Service Representative in Houston, TX. You will be the first contact for clients, answer inquiries, and help the Medical Records Department by retrieving records for patients, attorneys, and third-party vendors.

The role emphasizes accurate data entry, HIPAA compliance, and friendly patient communication. The ideal candidate has at least 1 year of medical customer service experience, familiarity with medical billing and EOB interpretation, and strong

Qualifications

• High School Diploma required.
• 1 year of experience in Customer Service in a Medical environment such as a clinic, hospital, or ER.
• Knowledge of medical billing and collection practices.
• Maintains confidentiality of patient data and medical records in compliance with HIPAA guidelines.
• Must be able to write and speak effectively in English.
• EMR, EDI, and Commercial Insurance Company systems.
• Detail-oriented and accurate data entry skills.
• Must be able to work well in a team environment.

Responsibilities

• Answer incoming phone calls from customers and identify the type of assistance needed.
• Document required information in computer systems as issues are identified.
• Resolve customer issues in real time through follow-up.
• Review healthcare claims and navigate multiple systems to verify details.
• Ensure proper benefits are applied to each claim.
• Communicate with patients to explain bills clearly and resolve questions.
• Meet performance goals in efficiency, accuracy and attendance.
• Provide support to the billing department as needed.

Skills

Customer service

Call center experience

Medical billing knowledge

Data entry

English proficiency

HIPAA awareness

Education

High School Diploma

Tools

EMR systems

EDI

Outlook

Windows OS

Job description

We are seeking an enthusiastic and dedicated Customer Service Representative to join our team. In this role, you will be the first point of contact for our clients, delivering exceptional service and support.

In addition to answering client inquiries and resolving issues, you will assist the Medical Records Department by retrieving records for patients, attorneys, and third-party vendors.

The ideal candidate will have:

Experience with medical insurance verification

Ability to interpret Explanation of Benefits (EOBs)

Strong data entry skills and attention to detail to maintain accurate records

Excellent communication skills and prior call center experience

A genuine passion for helping others and delivering outstanding customer service

If you thrive in a fast-paced environment and enjoy making a positive impact, we encourage you to apply!

Job Description- Customer Service Representative

Location: Houston, TX, 77041

Skills Required:

JOB SUMMARY: The Customer Service Representative is responsible for responding to patient account inquiries in compliance with corporate collections policies, processing patient payments, and generating patient statements.

DUTIES AND RESPONSIBILITIES:

• Answer incoming phone calls from customers and identify the type of assistance the customer needs.
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems.
• Own problems through to resolution on behalf of the customer/patients in real time through comprehensive and timely follow-up.
• Review and research incoming healthcare claims for patients by navigating multiple computer systems and platforms.
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures.
• Communicate and collaborate with patients to resolve issues, using clear, simple language to ensure complete understanding of their bill/statement.
• Meet performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction, and attendance.
• Problem-solving by identifying and resolving patient billing issues.
• Demonstrate excellence in Customer Service when speaking with patients on the phone.
• Continued Medical Education to stay abreast of current issues, trends, and changes in the laws and regulations governing medical billing.
• Provide support to other members of the billing department team as needed.
• Perform other duties as assigned.

COMPETENCIES:

• Analytical
• Design
• Problem Solving
• Technical Skills
• Customer Service
• Interpersonal Skills
• Oral Communication
• Teamwork
• Ethics
• Organizational Support
• Motivation

EDUCATION REQUIREMENTS:

High School Diploma

EXPERIENCE REQUIREMENTS:

1 year of experience in Customer Service in a Medical environment such as a clinic, hospital, or ER

SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

• Knowledge of principles and processes for providing customer services
• Knowledge of medical billing and collection practices
• Knowledge of basic medical coding and third-party operating procedures and practices
• Maintains confidentiality of patient data and medical records in compliance with HIPAA guidelines and regulations
• EMR, EDI, and Commercial Insurance Company systems
• Ability to represent the company in a professional manner and handle patient issues with sensitivity and confidentiality
• Detail-oriented and accurate data entry skills
• Strong organizational skills and the ability to prioritize workload
• Bilingual is helpful but not required
• Must be able to write and speak effectively in English
• Must demonstrate interpersonal skills with all levels of the billing and management team
• Must be able to work well in a team environment
• Must have basic computer literacy that includes keyboarding skills with the ability to utilize Outlook and to navigate in a Windows environment

WORKING ENVIRONMENT:

Ability to work in a fast-paced, high-volume, and dynamic environment. Able to flex hours and overtime to meet needs related to unanticipated volume, changes, and/or problems.