Customer Service Rep
Posted Updated
The Customer Service Rep - CHRG assists with held revenue by collecting required documentation, communicating with customers, and applying payer medical policy knowledge in alignment with standard operating procedures.
- Identifies opportunities that enhance operational efficiency and improve overall results
JOB FUNCTIONS
- Assists with held revenue by obtaining, reviewing, and validating required documentation to support claim resolution
- Communicates with customers, payers, and internal teams to gather information, clarify requirements, and resolve outstanding issues
- Applies knowledge of payer medical policies, coverage criteria, and reimbursement guidelines to ensure accurate claim processing
- Follows established standard operating procedures to maintain compliance, consistency, and quality in all workflows
- Monitors accounts for delays, missing documentation, or policy-related barriers and takes proactive steps to resolve them
- Identifies trends, gaps, or recurring issues that impact revenue flow and escalates or recommends solutions as appropriate
- Collaborates with team members to streamline processes, enhances operational efficiency, and improve overall performance results
- Maintains accurate records, notes, and documentation within company systems to support audit readiness and transparency
- Meets productivity, quality, and turnaround time expectations as defined by departmental standards
- Participates in training, policy updates, and continuous improvement initiatives to stay current with payer requirements and internal processes