We have an exciting RCM Custmer Services Associate opportunity. Pediatrix Medical Group is a physician lead organization, and we are one of the nation’s largest providers of prenatal, neonatal and pediatric services.

Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.  We offer a diverse range of opportunities, competitive salaries and benefits, and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team. 

The Customer Service Representative is responsible for effectively communicating with Pediatrix clients. Clients include, but are not limited to patients, parents or guardians of the patient, insurance companies, Human Resource Departments, Other Pediatrix employees. Customer Service Representatives will assist clients with balance inquiries, payment information, demographic updates, general billing issues, insurance/ Medicaid updates, and other account related issues. 

Operate Customer Service line.

• Provide clients with correct answer in regards to the account(s) in question.
• Verify and update account information.  This includes demographic information and correct insurance information.
• Obtain payment on accounts that are patient responsibility.  Payments include balance paid in full, settlements, and payment plans.  All must be within specific regional guidelines.
• Transfer accounts to appropriate queues for follow-up.
• Document all conversations with clients in Collections Plus Notes in the GPMS system for future reference.
• Handle client complaints in a professional and serious manner.
• Review accounts for accuracy (correct statement groups, financial class, etc.).
• Process adjustments as necessary (settlements, refund requests, etc.).
• Perform follow-up on worked accounts when necessary.
• Review and work daily correspondence received from patients.
• Assist with account audits when necessary.
• Elevate problems or trends to the department Manager.
• Perform a variety of other duties as directed by incoming calls.

Customer Service Liaison

• Serve as a liaison between Patient Accounts, payers, and clients when necessary (troubleshoot accounts, fax claims to insurance companies to expedite processing, service/ charge disputes).
• Contact payers to check claim status when beneficial to clients.
• Perform telephone appeals for denied or low payment claims when requested by client and within company established guidelines.
• Process disputes by obtaining medical records and explaining procedures.
• Review diagnosis and procedure codes with the Coding Department.
• Elevate accounts to Collection Administrators when appropriate.

Insurance Verification

• Work the insurance verification Tickler Queues when assigned.
• Verify new or correct insurance information on patients.
• Update account insurance sets.
• Send claims to the insurance company.
• Contact the patient or patient’s family if insurance information does not verify as eligible.
• Document the steps involved in the verification and claim submission process in Collections Plus Notes in the GPMS system.

Complete special projects and all other duties assigned by the Customer Service Manager. Adheres to all policies and procedures.

Benefits for Full Time employees and qualified dependents: 

• Medical, Prescription, Dental, Vision Insurance
• Progyny Fertility Benefits
• Livongo Diabetes Management
• Teladoc Health and Second Opinion Services
• Smart Shopper
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) – 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)**
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)**
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. 

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.