Managed Care Customer Service Representative

Job Description

This is an in office role that is responsible for providing customers, retail personnel, and insurance companies detailed information regarding invoices and explanations of balance due.

What Would You Do? The Specifics.

• Answers calls from customers regarding collection of past account accounts. Conducts conference calls with customers and insurance companies to determine the the responsible party for the balance and offers solutions of payment options.
• Provides detailed notes in our Point of System to communicate findings to retail associates and maintains notes in the ticketing system to track calls and the purpose of calls.
• Answers calls from retail personnel to assist with selecting the correct plans in the Point of Sale system and answer questions regarding plan calculations and why their customers received balance due notices.
• Writes off balance per store requests concerning store errors and forwards new plans to the Plan Setup Team to add into the Point of Sale.
• Answers calls from third-party payers and reviews line by line the details in order to determine the customer's responsibility and insurance responsibility.
• Completes a high-balance investigation to find new ways to prevent bad billings by researching insurance plans and insurance information. Makes outbound calls to insurance companies to inquire about the status of unpaid self-pay claims.
• Solves issues with insurance checks that go directly to the customers but belong to National Vision (NVI) by calling out to the customers to explain their balances owed.