TEKsystems · 1 day ago
Healthcare Customer Service
Rochester, NY, US
Full-time
Onsite
Entry, Mid Level
$18.25/hr - $18.50/hr
1+ years expTEKsystems is a leading provider of business and technology services, and they are seeking a Healthcare Customer Service professional to ensure full reimbursement for clinical services rendered. The role involves managing receivables, resolving claims, and collaborating with a dynamic team to improve business processes.
Information Technology
Responsibilities
Review and accurately process claim edits in a system work queue. Accurately handle claim adjustments and coverage changes as needed
Review and process claim denials according to established processes. Research and resolve denial issues via the payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals
Process account adjustments and refunds as needed according to department policy and procedure
Document actions appropriately and follow-up with payers to ensure they take actions promised. Follow-up on claims with no responses. Manage large workload using tracking tools to ensure we don’t fail to follow-up before a payer’s deadline
Participate in team meetings which review new procedures, new denial types and system updates. Report problems and patterns to the supervisor to help keep policies and procedures up to date with new clinical programs and payer policy changes
Acquire and maintain knowledge of system terminology, claim/denial/coverage concepts and terms, and relevant HIPAA privacy rules and other regulations. Expertly use insurance websites to explore denial issues and resolve them using the tools in Epic, including accessing clinical documentation and authorization details
Respond to patient complaints by researching coverage and claim processing to ensure the patient responsibility is accurate. Contact insurance as needed. Coordinate resolution with Customer Service staff
Qualification
Required
Ensure full reimbursement is received by the client for clinical services rendered including professional, long-term/home care and hospital care, by effectively and accurately managing a receivable
Resolve edits to ensure accurate claims are sent to primary and secondary insurances
Research and resolve denials and payer requests for information promptly and accurately in order to secure payment
Work as part of a dynamic team continually looking for ways to improve a complex business process
Review and accurately process claim edits in a system work queue
Accurately handle claim adjustments and coverage changes as needed
Review and process claim denials according to established processes
Research and resolve denial issues via the payer website, coverage policies and/or phone calls to the payer
Submit corrected claims and appeals
Process account adjustments and refunds as needed according to department policy and procedure
Document actions appropriately and follow-up with payers to ensure they take actions promised
Follow-up on claims with no responses
Manage large workload using tracking tools to ensure we don't fail to follow-up before a payer's deadline
Participate in team meetings which review new procedures, new denial types and system updates
Report problems and patterns to the supervisor to help keep policies and procedures up to date with new clinical programs and payer policy changes
Acquire and maintain knowledge of system terminology, claim/denial/coverage concepts and terms, and relevant HIPAA privacy rules and other regulations
Expertly use insurance websites to explore denial issues and resolve them using the tools in Epic, including accessing clinical documentation and authorization details
Respond to patient complaints by researching coverage and claim processing to ensure the patient responsibility is accurate
Contact insurance as needed
Coordinate resolution with Customer Service staff
Excellent problem solving, organizational and oral and written communication skills required
Successful completion of annual age and job specific competencies and skill verification tools required
Proficiency in a variety of computer applications and spreadsheet applications and common office equipment
Preferred
At least one year experience in a Medical Office environment preferred
Basic knowledge of medical billing, coding, collection processes, insurance policies and governmental regulation provision preferred
Knowledge of UBO4 billing form and 1500F05 specific payer requirements preferred
Benefits
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
10001+ employees
H1B Sponsorship
TEKsystems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (46)
2024 (52)
2023 (33)
2022 (22)
2021 (36)
2020 (53)
Funding
Current Stage
Late StageLeadership Team
Ryan Skains
Vice President, TEKsystems Global Services
Recent News
2025-11-19
2025-10-29
Company data provided by crunchbase