Healthcare Customer Service Specialist II

TL;DR

Healthcare Customer Service Specialist II (Healthcare/AI): Serving as the primary point of contact for healthcare providers and Medicare contractors to resolve complex inquiries and audit-related issues. Focus on maintaining compliance with CMS regulations, managing professional communications, and ensuring accurate documentation within the audit platform.

Location: Must be based in the United States

Company

hirify.global is a healthcare intelligence company providing an AI-powered platform to health plans to maximize financial outcomes and reduce healthcare costs.

What you will do

• Act as the primary point of contact for providers and Medicare contractors regarding audit inquiries.
• Manage inbound and outbound calls to resolve complex issues and confirm record receipt.
• Respond to written and electronic inquiries in a timely and professional manner.
• Educate providers on process protocols and appeal rights.
• Maintain accurate tracking logs and update the audit platform with all activity.
• Escalate critical concerns, legal actions, or government interventions to management.

Requirements

• Must be based in the United States
• At least two years of experience in a call center or customer service role
• High School diploma or GED
• Ability to learn and apply CMS rules and regulations
• Strong verbal and written communication skills
• Must maintain HIPAA Certification

Nice to have

• One year of claims processing or billing experience
• Knowledge of healthcare and insurance terminology

Culture & Benefits

• Equal opportunity employer committed to diversity and inclusion
• Participation in E-Verify program
• Professional work environment focused on healthcare innovation