New

Customer Service Representative (Exp in Healthcare/ Medical Billing)

22nd Century Technologies, Inc.
Pay Rate: $28.00/hr. on W2
United States, Texas, Austin
700 Lavaca Street (Show on map)
Apr 13, 2026
Job Title: Customer Service Representative (Exp in Healthcare/ Medical Billing) Location: Austin, TX 78702 Shift hours: Monday through Friday from 8:00A-4:30P Mode: onsite Pay Rate: $28.00/hr. on W2 Role & Responsibilities: Analyze billing inquiries to Medical Assistance to determine if the claim processed correctly and paid the correct amount. If the claim denied, they will determine the cause of the denial and explain to the provider the reason for the denial based off their knowledge of PA regulations and MA billing guidelines. Evaluate the providers Remittance Advice to explain to them their payments and assist them with their check details. This includes explaining any take back from Medical Assistance. Provide a proactive approach when answering calls from Providers and Recipients on the inquiry lines. This would include assisting the providers with how to bill their claims correctly. It would also include assisting recipients with understanding their benefit packages and locating providers. Evaluate billed information to determine if the proper procedure code and modifier were billed correctly. Also, determine if a procedure requires a prior authorization. Analyze claims to see if they meet 180-day exception criteria. Evaluate recipient's assigned eligibility to see what services they are eligible for under Medical Assistance. Assist recipients with reimbursement requests by educating providers on their contractual responsibilities under the MA program. Review previously billed services for potential duplicate billing. Provide dental history research to avoid duplicate billing or denied claims from occurring. Determine the need to refer issues to external agencies or to the Bureau of Program Integrity for review. Answer questions from the provider and recipient community on various topics on the inquiry lines. Consultant will assist the recipients and providers with their billing issues. Consultant, when requested, will work at one or more of the Department's work sites. Consultant's primary workstation will be at the Commonwealth Towers. Consultant will be provided with a desk, computer, and all items necessary for him/her to complete assignments. If Consultant is unable to appear at the scheduled work site at the pre-determined times, notification must be made to the Work Site Supervisor either prior to date or on date of absence. Consultant will be evaluated on. Quality of work product. Appropriateness of work habits. Growth of knowledge base and skill set. Effectiveness of communications. Education and Experience: Possess a high school diploma or GED. Should have knowledge of Medical Assistance and the billing process. Customer service and call center experience is preferred. Possess basic computer skills, including familiarity with Microsoft Office programs.