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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:

CA

Length of Study

12 weeks

Career Level

Gateway/Entry Level

Delivery Type

Asynchronous (Online)

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

Starting in this entry-level position will pave the way to more advanced training in telehealth, call center, business, and administration.

Day in the Life

You can contact customers by telephone or in-person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints. Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken. Check to ensure that appropriate changes were made to resolve customers’ problems.

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.

Disclaimer: Futuro Health reserves the right to change or update program requirements and qualifications at any time.