Client Support Representative

Job Title:

Client Support Representative (AI Patient Access Specialist)

Job Description

The Client Support Representative monitors AI-led conversations between healthcare representatives and insurance agents, guides the AI with accurate prompts and next steps, and seamlessly takes over when human interaction is required. This role sits at the intersection of healthcare administration, customer service, and machine learning, helping to verify insurance coverage, manage prior authorizations, and ensure that all information is captured and documented with precision.

Typical call volume ranges from 10-20 calls per day, with most calls lasting around 5 minutes and more complex insurance verification calls extending up to 30-45 minutes.

Responsibilities

+ Monitor AI-led agent-to-agent conversations between healthcare representatives and insurance agents to ensure accuracy and continuity.

+ Drive AI interactions by selecting appropriate prompts, guiding responses, and determining next steps during each conversation.

+ Take over calls when the AI cannot proceed, when an agent prefers to speak with a human, or when carrier or contract requirements mandate human interaction.

+ Review notes from existing conversations and quickly pick up where another specialist or the AI left off, maintaining a seamless experience.

+ Serve as the human-in-the-loop, teaching the AI system how to navigate the complexities of healthcare reimbursement and insurance processes.

+ Verify insurance eligibility, benefits, and coverage details with a high level of accuracy and professionalism.

+ Gather and document prior authorization information and conduct related follow-up with insurance agents and other stakeholders.

+ Conduct insurance verification and follow-up activities to capture complete and accurate information before concluding calls.

+ Maintain detailed notes during and after each conversation, ensuring all relevant information is captured and clearly documented.

+ Accurately document insurance verification and prior authorization details in internal systems and tools.

+ Review all information for completeness and accuracy before closing interactions or moving on to the next task.

+ Manage both outbound and inbound call workflows while maintaining quality, accuracy, and adherence to established processes.

+ Navigate multiple systems and screens efficiently during calls to access, update, and verify information.

+ Follow established workflows, directions, and processes to ensure consistent handling of insurance verification and prior authorization tasks.

+ Collaborate with AI-driven technology and adapt to evolving tools, prompts, and workflows as the system improves.

+ Provide a high level of customer service and professionalism in all interactions with insurance agents and healthcare representatives.

+ Apply strong listening, comprehension, and communication skills to understand context from previous notes and continue conversations seamlessly.

+ Support process improvement efforts by consistently applying best practices and identifying opportunities to enhance accuracy and efficiency.

Essential Skills

+ High School Diploma or GED.

+ Basic computer proficiency and the ability to learn new systems and technology quickly.

+ Proven data entry and documentation skills with strong attention to detail.

+ Experience navigating multiple systems and screens while handling calls and documentation.

+ Customer service experience of at least 6 months in a call center, client support, or similar environment.

+ Strong listening, comprehension, and verbal communication skills.

+ Ability to provide a high level of customer service and professionalism in all interactions.

+ Ability to work independently while following directions and established processes.

+ Solution-oriented mindset focused on resolving issues and moving conversations forward.

+ Ability to quickly absorb information from previous notes and continue a conversation without missing critical details.

+ Coachable and adaptable approach to new technology, AI tools, and evolving workflows.

+ Demonstrated ability to manage both inbound and outbound calls while maintaining quality and accuracy.

+ Comfort working with AI-led conversations and acting as the human-in-the-loop in a technology-enabled environment.

Additional

Skills & Qualifications

+ Experience in healthcare administrative or customer service roles, such as Healthcare Receptionist, Medical Office Assistant, Healthcare Call Center Representative, Patient Access Representative, Pharmacy Technician or Support, Medical Administrative Assistant, or Healthcare Internship.

+ Recent college graduates with strong communication and technology skills are encouraged to apply.

+ Background in health care, insurance verification, or prior authorization support is highly beneficial.

+ Experience in call center, customer support, customer care, or client services environments.

+ Familiarity with call monitoring and call support functions.

+

Experience with documentation and data…