RCM Customer Service Representative

Location: Tijuana, Baja California, Mexico. Work hours: Monday through Friday, 5:00 AM PST to 2:00 PM PST, aligned with East Coast business hours.

Company

hirify.global is a medical technology company developing clinically differentiated products, services, and integrated technologies for orthopedics and active lifestyles.

What you will do

• Manage complex patient cases from initiation through resolution and serve as the primary contact for escalated patient, provider, and payer inquiries.
• Explain medical, insurance, reimbursement, benefit, and therapy-related information to patients and healthcare providers.
• Resolve advanced customer service issues, reimbursement challenges, complaints, and sensitive patient situations with minimal supervision.
• Mentor Patient Services Representatives I and II and support onboarding, training, and knowledge-sharing initiatives.
• Collaborate with Sales, Information Technology, Service, Manufacturing, and other departments on patient support, testing, and new initiatives.
• Maintain accurate case documentation, monitor progress, and identify workflow improvements while meeting quality, productivity, service-level, and compliance expectations.

Requirements

• High school diploma or equivalent; an associate's or bachelor's degree is preferred.
• 3–5 years of customer service, patient services, reimbursement, healthcare support, or related experience.
• 2–3 years of bilingual voice experience in English and Spanish in a healthcare, patient support, call center, or customer service environment.
• Fluent bilingual English and Spanish proficiency is required.
• Experience managing escalated customer service situations and complex patient cases, with strong conflict resolution, de-escalation, analytical, and problem-solving skills.
• Proficiency with CRM systems, patient management tools, and Microsoft Office; advanced understanding of healthcare reimbursement and insurance benefit structures.

Culture & Benefits

• Work in a culture focused on continuous improvement, innovation, and measurable patient outcomes.
• Support patients, healthcare providers, insurance carriers, and internal stakeholders across multiple departments.
• Work independently with limited supervision while contributing to team mentoring and process improvement.
• Maintain high standards of professionalism, accountability, patient care, and customer service.