Healthcare Customer Service Paraprofessional
Customer Service Professionals engage with customers to provide basic information and scripted responses to routine inquiries about products and services. They resolve general complaints, not installation, sales, repair, or technical support. Health plans (medical coverage, claims, referrals, eligibility), delivery systems (appointment access, service complaints, physician selection, fee quotes, billing), and governance issues are addressed.
These professionals manage patient access and registration in a management system, answering phones, scheduling appointments, processing referrals, and fielding billing questions. They coordinate billing with patients, patient financial services, and the health plan. Their customer service skills and HIPAA compliance make them patients’ first point of contact.
Available in:
Length of Study
Career Level
Delivery Type
Duties
- First Point of Contact: May act as the patients’ first point of contact with health service provider/ system.
- Customer Interaction: Interact with customers to provide primary or scripted information in response to routine inquiries about products and services. Handle and resolve general complaints, excluding tasks related to installation, sales, repair, and technical support.
- Complaint Resolution and Education: Resolve complaints and inquiries. Provide education to members, prospective members, providers, insurance carriers, agents, brokers, attorneys, employer groups, and other representatives through written communication, in-person interactions, and telephone conversations. Address health plan-related issues (medical coverage, claims, referrals, eligibility), delivery system issues (appointment access, service complaints, physician selection, fee quotes, patient billing), and governance issues (voting member information, consumer governance policies). Verify patient demographics and insurance coverage.
- Patient Access and Registration: Perform general patient access and registration duties in a management system. Answer telephones, make appointments, process referrals, and maintain provider templates and appointment schedules.
- Patient Account Management: Manage patient accounts, obtaining prior authorization for services. Process items in appropriate work queues to complete registration and enter service capture data. Ensure patient accounts and coverage structures meet the standards and billing requirements of various payors.
- Liaison and Communication: Function as a liaison to Patient Financial Services and the Health Plan. Communicate with external government payors and employers as necessary.
- Billing and Financial Tasks: Work directly with patients on billing-related matters. Provide fee estimates to patients for services. May perform duties related to cash collection and depositing.
- Skills and Compliance: Demonstrate strong customer service and communication skills. Adhere to HIPAA and patient confidentiality requirements.
Career Opportunities
Day in the Life
Job Outlook
California has a projected growth of 4% between 2021-2030, with a median annual salary of $44,280.
Colorado has a projected growth of 11% between 2021-2030, with a median annual salary of $39,410.
Washington has a projected growth of 17% between 2021-2030, with a median annual salary of $44,790.
Oregon has a projected growth of 5% between 2021-2030, with a median annual salary of $39,090.