Healthcare Customer Service Specialist II

Machinify

Primary contact for all provider inquiries in healthcare customer service. Working with a team to ensure timely responses and effective communication.

Posted 7/13/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider communication, claims processing, and compliance with Medicare regulations. Proficient in maintaining accurate records and responding to inquiries in a timely manner while ensuring adherence to HIPAA standards.

Highest-signal resume keywords

Provider CommunicationClaims ProcessingCustomer ServiceHIPAA CertificationResearch and Due Diligence

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingBilling ExperienceRecord KeepingInquiry ResolutionData Entry

Soft Skills

Professional CommunicationRelationship BuildingProblem SolvingTimelinessAttention to Detail

Tools & Technologies

Audit PlatformTracking Logs

Certifications & Qualifications

HIPAA Certification

Industry Keywords

MedicareCMSHealthcare ProvidersContract RequirementsProcess Protocols

About the role

Key responsibilities & impact

Work within a team as the primary point of contact for all providers, Medicare contractors, etc.
Provide professional, accurate and timely responses to CMS (Medicare) and provider inquiries.
Maintain a 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 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 as necessary.
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, and suggestions to improve or correct processes or documents.
Perform miscellaneous duties as assigned in a highly professional manner.

Requirements

What you’ll need

At least two years’ experience in a call center or customer service position required.
At least one year claims processing/billing experience preferred.
High School diploma or GED is required.
Must maintain HIPAA Certification.

Benefits

Comp & perks

Equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status.
Proud to be an equal opportunity workplace.
Employment at will.