Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

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HCS Customer Service Specialist II (SCA)
Job Code:2021-50-4-027
Location:San Angelo, TX
Status:Regular Full Time
  
Responsibilities:
***NOTE COVID-19***: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company.

Customer Service Specialist II (SCA)'s
 are the primary points of contact for all providers, Medicare contractors, etc. They provide professional, accurate and timely responses to CMS and provider inquiries.  This includes responding to written, telephonic, and electronic inquiries within the appropriate timeframes.  

Essential duties:

• Maintain current knowledge of all contract requirements and objectives
• Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors
• Take inbound calls from providers to answer questions and resolve complex issues 
• Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received
• Respond to assigned written communications from providers timely and accurately  
• Educate providers on proper process protocols and their appeal rights
• Establish appropriate contacts and perform necessary research to validate provider contact information
• Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry
• Enter and update all contact and activity information into tracking logs and the audit platform where not automatically completed by the system, e.g., a telephone call is made, correspondence responses, special notes, etc. 
• Research and route internal/external communications to the appropriate person or department
• Notify management of:  
    • all escalated displeasure with the audit program
    • legal action 
    • government intervention
    • escalated concerns regarding audit issues and edit parameters 
    • suggestions to improve or correct processes or documents
• Maintain HIPAA Certification (process provided by the Company)
• Perform miscellaneous duties as assigned in a highly professional manner



*Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.
Required Skills and Knowledge:


• Excellent verbal and written communication skills
• Skilled in data entry and knowledge of computers
• Courteous, professional, and respectful attitude
• Strong understanding of customer service policies and processes
• Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program
• Healthcare and insurance terminology knowledge preferred but not required. 
• Flexibility to prioritize and handle non-standard situations that may arise
• Must be detailed, organized and able to manage various job duties as required
• Maintain a strong work ethic and attendance
 

•Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Physical Requirements:

**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company.

-Job is in a busy standard is performed in an office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company using an office telephony system; views a computer monitor, types on a keyboard and uses a mouse.
-Reads and comprehends information in electronic (computer) or paper form (written/printed).
-Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.
-Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.
-Consistently communicates on the phone; headset is also provided.
-Occasionally lift/carry/push/pull up to 10lbs.
Education and Experience:


• High School diploma or equivalent
• 2+ years’ experience in a call center or customer service position
• 1+ years claims processing/billing experience preferred but not required
 





Other Requirements:

• Must submit to and pass pre-hire background check, as well as additional checks throughout employment
• Must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
• Must not have any Federal or State liens resulting from County, State or Federal tax issues.
• Must not have any current defaulted student loans.
•Performant is a government contractor. Assignments for this position require timely submission to and successful outcome of background and government clearance as a condition of offer of employment and post hire condition of continued employment with the Company.
• Must submit to and pass drug screen pre-employment (and throughout employment). Performant is a Drug-Free Workplace.
 
This Job Profile is subject to change at any time.

Visa sponsorship is not available.

Job Profile is subject to change at any time. 

EEO
Performant Financial Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER