Patient Care Service Representative
hace 6 meses
Descripción y detalle de las actividades
Patient Care Service (PCS) Representatives seek benefit coverage for patients from insurance groups with the responsibility of timely and compliant order entry, benefit verification and prompt follow up. This position works collaboratively with cross-functional internal and external teams to obtain necessary documentation required to obtain insurance authorizations. Essential Duties and Responsibilities: - Answers inbound and outbound calls, research, and identifies insurance to ensure compliant/proper account resolution. - Verifies insurance eligibility and follows coordination of benefits guidelines. - Faxes accurate and thorough Pre-Authorization Request Letters. - Determines revenue amounts based on allowable, benefits, unit price, payer guidelines, copayment and contract pricing. - Submits appropriate and accurate billing to Government entities and private insurance payers consistent with Federal, State and insurance specific requirements. - Pursues supporting documentation from Sales Team to ensure all required documents are received prior to invoicing. - Reviews prescriptions, Letters of Medical Necessity and/or Chart Notes to ensure both completeness and accuracy. - Ensures that orders meet criteria and compliance standards, and resolves assigned denials and variances by accurately determining the root cause and collaborating to reduce the denial or variance. - Works to resolve submission issues which can include obtaining the appropriate Medical Record documentation or validation of coding. - Reviews orders for accuracy and completeness prior to providing the “OK to Place” and invoicing. - Processes assigned correspondence and telephone inquiries from patients and payers in a compliant manner and promptly responds in writing or verbally. - Appropriately challenges insurance companies by communicating information on Medical Necessity and negotiating coverage and pricing for the purchase of our products that meet all applicable payor guidelines. - Serves as back-up for other PCS Representatives and their assigned region(s), as needed.
Experiência y requisitos
**Número de vacantes** 1
**Área** Atención a Clientes/Call Center/Telemarketing
**Contrato** Permanente
**Modalidad** Presencial
**Turno** Diurno
**Jornada** Tiempo Completo
**Estudios** Preparatoria
**Sexo** Indistinto
**Disponibilidad p. viajar** No
-
Patient Care Service Representative
hace 6 meses
Tijuana, México Enovis México A tiempo completo**PLEASE DO SEND YOUR RESUME AT ENGLISH** **Job Summary** Patient Care Service (PCS) Representatives seek benefit coverage for patients from insurance groups with the responsibility of timely and compliant order entry, benefit verification and prompt follow up. This position works collaboratively with cross-functional internal and external teams to obtain...
-
Patient Care Service Representative
hace 1 semana
Tijuana, Baja California, México Enovis A tiempo completoJob SummaryWe are seeking a highly skilled and detail-oriented Patient Care Service Representative to join our team. As a Patient Care Service Representative, you will be responsible for communicating benefit information to patients, physicians, and insurers, interpreting medical and insurance information, and providing case management services.About the...
-
Patient Care Service Representative
hace 6 meses
Tijuana, México Enovis A tiempo completoJob Description: Communicates benefit information to patients, physicians and insurers who provide insurance verification as required. Interprets medical and insurance information for clients. Responsible for case management with patients, physicians and insurers primarily over the telephone. Provides detailed, technically complex information to patients to...
-
Telepsychiatry Patient Care Coordinator
hace 3 semanas
Tijuana, Baja California, México Gaba Telepsychiatry A tiempo completoGaba Telepsychiatry is a leading provider of mental health services, and we're seeking a skilled Front Desk Representative to join our team. As a key member of our customer service team, you'll play a vital role in ensuring that patients feel welcome and supported throughout their journey with us.This is an exciting opportunity for someone who is passionate...
-
Patient Care
hace 6 meses
Tijuana, México Empleando Mexico A tiempo completo**Vacante para la empresa Empleando Mexico en Tijuana, Baja California**: We're hiring! Join Our Team as a Dental Patient Coordinator! Are you a compassionate and detail-oriented individual with excellent communication skills? Our dental clinic in Tijuana is seeking a dedicated and enthusiastic Patient Coordinator to join our team. Position: Dental Patient...
-
Customer Service Representative
hace 4 semanas
Tijuana, Baja California, México Gaba Telepsychiatry A tiempo completoGaba Telepsychiatry, a leading telepsychiatry company, is seeking an experienced Customer Service Representative to join our team. As a vital member of our operations, you will play a key role in ensuring patients feel welcomed and supported.Your primary responsibility will be to serve as the initial point of contact for patients seeking mental health...
-
Customer Care Team Lead
hace 6 meses
Tijuana, México Integon Service Co. A tiempo completoJob Summary: The Customer Care Operations Specialist is responsible for contributing to the leadership of the Customer Care team by mentoring representatives, monitoring and coaching performance, resolving escalated calls and providing advice and guidance to support achievement of department quality and productivity standards Key Responsibilities: - Coach...
-
Front Desk Executive
hace 6 meses
Tijuana, México Gaba Telepsychiatry A tiempo completoGaba Telepsychiatry is looking for Front Desk Representative. As a Healthcare Customer Service Provider, your primary responsibility is ensuring patients feel welcomed and supported. In this role, you will serve as the initial point of contact, requiring a genuine sense of empathy, compassion, and understanding for those seeking mental health support. Your...
-
Customer Service Representative
hace 1 semana
Tijuana, Baja California, México Enovis México, S.A. De C.V. A tiempo completoEnovis México, S.A. De C.V. está buscando a un profesional apasionado y motivado para el cargo de Patient Care Service (PCS) Representative. Esta posición es crucial en nuestro equipo de atención al cliente, donde trabajamos arduamente para asegurar que nuestros clientes obtengan la mejor atención posible.Nuestro representante de PCS es responsable de...
-
Customer Service Representative
hace 2 meses
Tijuana, México Integon Service Co. A tiempo completoJob Title: Customer Service Representative - **This is an on-site and full-time position in Tijuana, Baja California.**_ About Integon Integon is a division in Mexico of one of the largest insurance companies in the United States of America. Since 2019, it has been certified as a Great Place To Work. Integon provides support to its insurance company...
-
International Patient Coordinator
hace 6 meses
Tijuana, México Tijuana Call Center A tiempo completoJoin Our Team as a International Patient Coordinator! Who We Are: We are a company committed to providing quality, accessible healthcare to our diverse community. We value inclusivity and patient-centered care every step of the way. **Job Description**: As a Bilingual Patient Coordinator, you'll be the vital link between our patients and our medical team....
-
Customer Service Representative
hace 6 días
Tijuana, Baja California, México Reclutamiento 3R A tiempo completo**Job Title:** Customer Service Representative**About the Job:** We are seeking a highly skilled Customer Service Representative to join our team at Reclutamiento 3R in Tijuana, Baja California. As a Customer Service Representative, you will be responsible for providing exceptional customer service to policyholders, promoting a reliable image of the company...
-
Customer Service Representative
hace 6 meses
Tijuana, México Ossur México, S. de R. L. de C.V. A tiempo completoDescripción y detalle de las actividades As the Customer Care Representative, you will ensure that customers receive the best service possible through processing orders, dealing with incoming calls, and working together with other departments cross-functionally to ensure the best possible outcome for our customers. Contributing towards the strategy and...
-
Customer Service Representative
hace 2 semanas
Tijuana, Baja California, México North American Production Sharing A tiempo completoWe are seeking a highly skilled Customer Service Representative to join our team at North American Production Sharing in Tecate, Mexico.**Estimated Salary:** $25,000 - $40,000 per year**Job Description:** As a Customer Service Representative, you will be responsible for providing exceptional support to our clients by meeting with new accounts during the...
-
Dentist Clinic Customer Service Representative
hace 3 semanas
Tijuana, Baja California, México Nice2Chat A tiempo completoThe role requires a highly skilled and customer-focused professional to provide exceptional service to patients at a dental clinic in the US.Key Responsibilities:- Schedule and confirm appointments with patients, ensuring timely communication and follow-up- Provide multilingual support to cater to diverse patient needs, utilizing strong English and Spanish...
-
Customer Service Representative
hace 1 mes
Tijuana, Baja California, México Tap A tiempo completo**Vacante para la empresa Tap en Baja California**:Our Call Center in Tijuana is seeking a skilled Customer Service RepresentativeAs a Customer Service Representative, you will be responsible for providing exceptional service to our clients through the phone. You will be the face of our company and your interactions will have a direct impact on our...
-
Medical Insurance Benefits Coordinator
hace 1 semana
Tijuana, Baja California, México Enovis México A tiempo completoJob SummaryPatient Care Service Representatives at Enovis México work collaboratively with internal and external teams to seek benefit coverage for patients from insurance groups.The role involves timely and compliant order entry, benefit verification, and prompt follow-up. This position requires strong communication skills, attention to detail, and a...
-
Customer Service Representative
hace 2 semanas
Tijuana, Baja California, México Confie A tiempo completoAt Confie, we are committed to providing world-class care to our clients as a Customer Service Representative. This role is ideal for individuals who thrive in diverse retail environments and are passionate about delivering exceptional customer experiences.About the RoleThis position involves processing insurance policy changes, handling client inquiries,...
-
Bilingual Patient Coordinator
hace 6 meses
Tijuana, México CHIPSA Hospital A tiempo completoCHIPSA Hospital is looking for a Bilingual Patient Coordinator to enhance our patients' experience by serving as liaison between patients and all the services - Greet new patients, provide hospital tour and fill out registration forms. - Hand out and collect patient surveys and provide to PET Rep. - Ensure patients attend Treatment & Motivational Classes. -...
-
Customer Service Representative
hace 3 semanas
Tijuana, Baja California, México Confie A tiempo completoOverviewSeguros Confie, a leading national insurance distributor with over 700 locations in the US, is seeking highly motivated individuals to join our team as Customer Service Representatives in Tijuana, Mexico.We offer a unique opportunity for candidates to develop their skills in customer service and sales while working in a fast-paced environment. Our...