Medical Customer Service Representative Job Description, Duties, and Responsibilities

This post provides exhaustive information on the medical customer service representative job description, including the key duties, tasks, and responsibilities they commonly perform.

It also highlights the major requirements you may be expected to fulfill to be hired for the medical customer service representative role by most recruiters/employers.

What Does a Medical Customer Service Representative Do?

Medical customer service representatives are literally the voice of a brand, and foster strong relationship between the organization they represent and their customers.

The medical customer service representative job description entails providing customer support duties, which include interacting with customers to handle complaints, process orders, and provide information about an organization’s products and services, etc.

It also involves successfully managing large amounts of inbound and outbound calls, sometimes on multiple lines phone system; this may include handling different topics, following communication scripts, and being a contact point between customers and the company.

Medical customer service representatives work in hospitals, medical offices, clinics, insurance companies, nursing homes, etc.

They are responsible for evaluating all documents to ensure that appropriate information has been obtained for billing purposes.

Their role also involves handling patients’ complaints, referral sources, and administrative department inquires.

The job of a medical customer service representative requires them to manage all aspects of patient intake; data entry, answering the phone, outbound calling, and receiving faxes; maintaining referral source information and log, and data input into IMBS.

Their duties also include communicating with insurance offices for authorization request, as well as conducting insurance verification and eligibility for services/products.

Customer service representatives are responsible for coordinating, collecting, and imputing all patient information and new patient set-ups into a customer information system.

They must also develop and maintain a working knowledge of current Medicare, Medicaid, insurance regulations, products and services offered by the organization they represent, and FDA/DOT, JCAHO and all applicable governmental guidelines and regulations.

They are also responsible for ensuring customer satisfaction by assisting them with issues and concerns related to their health, making decisions as needed off-hours or without supervision to ensure uninterrupted supply of product to customer.

Also, the work description of medical customer service representatives entails conducting patient satisfaction calls and acting as patient advocate to resolve questions or concerns, and ensuring to follow an issue through to its conclusion.

It also entails building and maintaining relationships with locations, patients, and referral sources.

Customer service representatives ensure to clear previous day’s route; they are responsible for the accuracy and completeness of all paperwork.

They are responsible for assembling charts and processing paperwork, including preparation of files for the Billing Department and complete batch reports for UPS deliveries.

They must also be available for on-call assignments as required.

To become a medical customer service representative, you require a minimum of High School Diploma or GED, but an Associate or College Degree is preferred.

It is also important to posses a strong customer service background and knowledge of medical terminology.

To be successful in your career, you require excellent customer service and problem-solving skills, the ability to work both independently and as part of a team, and time-management and organizational skills; exceptional verbal and written communication, interpersonal, and active-listening skills; phone handling skills, as well as the ability to prioritize issues and respond accordingly.

Computer skills for data entry and database management are also vital skills to have to be effective as a medical customer service representative.

Medical Customer Service Representative Job Description Example/Sample/Template

Medical customer service representatives provide customer support, visitor reception, and patient intake and discharge duties.

The job functions they perform may vary slightly depending on the setting they work.

The major tasks, duties, and responsibilities performed by the medical service customer representatives are listed in the sample job description below:

• Responsible for maintaining referral log
• Performs basic inventory duties by monitoring office supplies
• Responsible for collecting co‐pays and deductible amounts
• Responsible for preparing and completing CMNs/SOPs for Sales Reps and documents on tracking log in settings where applicable
• Responsible for preparing tickets for routes daily and coordinates timely fulfillment of products and services ordered
• Responsible for educating referral sources, patients, and employees on qualifications for service and 3rd party billing
• Ensures to provide service for walk-in patients and walk-in equipment requests
• Responsible for providing technical assistance to customers as required
• Ensures questions and concerns are processed and communicated with patients and referral sources both verbally and in writing in a timely manner
• Effectively communicates Service Excellence with location employees
• Ensures to adhere to established guidelines for service delivery, and comply with applicable laws and regulations
• Always maintains a positive and constructive attitude
• Ensures to adhere to and implement all company policies and procedures, including but not limited to clinical programs
• Resolves all customer questions or concerns via multiple media; the phone, email, online chat or social media
• Responsible for maintaining and updating customer information as needed
• Attempts to resolve and de-escalate any issues in a calm manner
• Ensures to escalate calls or challenges to supervisor when necessary and appropriate
• Responds to requests for assistance and/or possible processing of credit card authorizations in a timely manner
• Responsible for tracking call-related information for auditing and reporting purposes
• Ensures to provide feedback reports on call issues related to downtime and/or training issues
• Up-sells the services of the company/organization to customers as necessary
• Exhibits a detail oriented etiquette and friendly attitude at all times when answering telephone calls
• Appropriately schedules patient appointments for consultations, evaluations, treatments, follow-up, or re-evaluation
• Responsible for maintaining and updating patient medical records.

Download job description template.

Medical Customer Service Representative Requirements – Skills, Knowledge, and Abilities for Career Success

When hiring for the position of medical customer service representative, recruiters commonly require prospective applicants to possess certain skills, knowledge, abilities, etc. to be considered for the job.

This is to ensure that such candidates will be able to effectively perform the obligations, objectives, and purpose of the customer service representative position set by the organization and succeed in their career.

If you are seeking the role of a medical customer service representative, here are major employers’ requirements you may be expected to satisfy to qualify for an interview:

• Education: A minimum of High School Diploma or GED is required to work as a medical customer service representative. However, an Associate Degree or higher level of education is strongly preferred
• Knowledge: Understanding of medical terminology, medical billing practices and billing reimbursement is essential to provide medical support in a healthcare setting
• Customer service representative must also be familiar with office procedures used in medical offices, hospitals, and other healthcare facilities
• The knowledge or ability to quickly learn commonly used concepts, practices, and procedures is critical for success
• A strong customer service background and knowledge of insurance policies are required. Also, at least 1 year of medical call center experience is a plus and demonstrated flexibility to adapt to changes in procedures and job assignments is required
• Excellent oral and written communication skills: Ability to communicate effectively and professionally with patients, visitors, physicians, and coworkers. It is also vital that medical customer service representatives express ideas clearly, both verbally and in writing, as well as provide strong documentation
• Strong active listening/comprehension skills: They must be able to listen actively to comprehend and decode the customers’ message as well as deduce what is implied in the communication
• Team work abilities: Customer service representatives must be able to function in a team oriented environment as well as independently deliver results
• Phone handling skills: Their job involves handling a great volume of calls to take inquiries, provide information, or handle complaints; hence it is essentials that they have the required etiquette to provide customer support in a positive, calm, and timely manner. Phone-related customer service experience is a major plus
• Bilingual language skills: The ability to speak multiple languages is a plus, especially in a situation with large customer contact with different languages
• Time-management and organizational skills: This skill is necessary for medical customer service representatives to effectively manage multiple expectations in a fast-paced environment
• Attention to detail: They must be able to demonstrate extreme attention to detail to ensure accuracy for electronic and print data entry and update of medical records
• Strong sense of urgency and responsiveness to customers is essential for a medical customer service representative
• Computer skills: Customer service representatives require strong keyboarding skills and advanced knowledge in the use of all Microsoft Office applications, especially Word and Excel proficiency. Internet proficiency and knowledge of email management tools are also essential
• Physical dexterity: The medical customer service representative job description requires sitting, walking and standing, talking or listening. It also requires close vision to small print on computer and/or paperwork; lifting and transporting of patient equipment and/or move full and empty cylinders; contact with patients and equipment with potential exposure to contagious pathogens. It may also require the ability to load, push, pull, and lift oxygen concentrators, oxygen tanks, portable oxygen units, positive airway pressure devices, wheelchairs, power wheelchairs, scooters, hospital bed parts, walkers, commodes, and other home medical equipment and supplies in and out of location, warehouse, company vehicle, patient residence, etc.
• Technical abilities: They must possess working knowledge of office equipment such as fax machine, copier, printer, and PC, as well as ability to perform basic preventive maintenance duties.

Conclusion

Employers needing to hire for the position of medical customer service representative in their companies will find this post, including the sample job description provided, useful in creating a suitable description of the role that can help them attract the best candidates for the job.

Individuals who are interested in starting a career in the customer service field will also find this article beneficial in learning about what the medical customer service representative role entails and how they can be achieve success on the job.

Did this post help improve your knowledge of what medical customer service representatives do? Please, leave a comment in the box. Do also share your job description if you work as a customer service representative in a medical setting.