Medical Billing Customer Service Representative Job Description

Updated on: November 3, 2017

Position Overview

A medical billing customer service representative is responsible for contacting insurance carriers, patients, and other facilities to obtain information on accounts, and to identify issues and resolve them.

These individuals are hired specifically to provide medical billing companies or medical concerns with assistance in sorting out their billing work, and creating and maintaining an effective liaison with external agents.

Position Requirements

While a high school diploma or a GED equivalent is sufficient to work as a medical billing customer service representative, it is imperative for people aspiring to work at this position to possess some knowledge of the medical billing world, and preferably have some experience in it too. Having worked in a prior medical billing capacity will make you an excellent candidate to hire, and you will top the list of shortlisted candidates for sure.

As a medical billing customer service representative, it is essential that you possess exceptional communication skills, and a great ability to handle and resolve issues before they become crises. Good phone manner is essential if this is the work that you want to do, as you will be performing a lot of duties that pertain to customer contact. Also, it is imperative for people working as medical billing customer service representatives to be meticulous in their work, and be able to multitask effectively.

The following list of duties will show you what a medical billing customer service representative is required to do on any given day at work:


Medical Billing Customer Service Representative Duties


• Take and respond to a high volume of calls each day, providing required information to external agents and patients.

• Provide callers with information regarding their statements, and copays, and ensure that any outstanding payments are communicated to them.

• Answer questions regarding insurance coverages, and pre-qualifications for insurance modules and riders.

• Collect information regarding delinquent accounts, and make arrangements for payments, while remaining within the parameters of facility protocols.

• Initiate claims, perform appropriate paperwork and documentation, and contact insurance companies regarding statuses of unpaid or filed claims.

• Provide patients with information regarding services, rates, and billing matters, and ensure that any additional costs are also communicated to them.

• Update patients’ records in predefined hospital or facility systems, ensuring that they are kept confidential and safe.

• Follow up with patients to ensure that they pay their debts on time, providing them with easy payback options.

• Coordinate efforts with collection agencies to collect outstanding claim amounts, and determine appropriateness for perusing legal remedies .