Customer Service Specialist

Customer Service Specialist

Location: Chicago, IL 60643

Work Type: Full-Time, On-Site

Are you passionate about helping others and looking for a career with purpose? At Activ Style, we're dedicated to improving lives by providing essential home-delivered medical supplies that help individuals maintain their dignity, independence, and quality of life.

We're currently seeking a Customer Service Specialist to join our team in Chicago, IL. In this role, you'll serve as a trusted resource for our clients, helping them obtain vital products such as incontinence supplies, urological products, and other personal care essentials delivered directly and discreetly to their homes. If you enjoy building connections, solving problems, and making a difference in the lives of others, we'd love to hear from you.

Customer Service Specialists are responsible for learning and understanding the entire front-end and resupply process to ensure successful service for our patients. You'll work in a fast-paced environment answering inbound calls and making outbound calls. You may be responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and scheduling patients to receive supplies or equipment as ordered by their doctor.

Customer Service Specialists educate patients about their financial responsibility when applicable.

• Develop and maintain working knowledge of current products and services offered by the company
• Answer all calls and emails in a timely manner, in adherence to performance goals
• Document all call information according to standard operating procedures
• Answer questions about products, services, retail stores, and general service line information based on customer needs
• Process orders, route calls to appropriate resources, and follow up on customer calls where necessary
• Review all required documentation to ensure accuracy
• Accurately process, verify, and submit documentation and orders
• Complete insurance verification to determine patient eligibility, coverage, co-insurances, and deductibles
• Obtain pre-authorization if required by an insurance carrier and process physician orders for approval
• Navigate multiple online EMR systems to obtain applicable documentation
• Enter and review all pertinent information in EMR system including authorizations and expiration dates
• Communicate with Customer Service and Management regarding noticed trends with insurance companies
• Verify insurance carriers are listed in the company's database system and request new carriers be entered when needed
• Contact patients when documentation doesn't meet payer guidelines to provide updates and offer additional options
• Meet quality assurance requirements and other key performance metrics
• Facilitate resolution on customer complaints and problem-solving
• Pay attention to detail with great organizational skills
• Actively listen to patients and handle stressful situations with compassion and empathy
• Be flexible with work schedules and hours of operation
• Utilize company-provided tools to maintain quality, including Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, and PECOS
• Maintain patient confidentiality and function within HIPAA guidelines
• Complete assigned compliance training and other educational programs as required
• Maintain compliance with Activ Style's Compliance Program
• Retain knowledge of and consistently adhere to procedures for Personal Protective Equipment (PPE), infection control, and hazardous materials handling
• Perform other related duties as assigned

• High School Diploma or equivalent
• One (1) year of work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management
• Experience in a Medicare-certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance is preferred
• Excellent customer service skills
• Analytical and problem-solving skills with attention to detail
• Strong decision-making abilities
• Excellent verbal and written communication skills
• Ability to prioritize and manage multiple tasks simultaneously
• Proficient computer skills and knowledge of Microsoft Office
• Ability to adapt and be flexible in a rapidly changing environment
• Ability to work independently as well as follow detailed directives
• Mental alertness to perform essential functions of the position

• General…