Senior Process Executive – Customer Service (Voice)

Job Designation: Senior Process Executive Customer Service (Voice)

Required Experience: 1-3 years

Domain Knowledge: US Healthcare (RCM Voice / Inbound Customer Service / Denial Management)

Employment Type:Full-time/Permanent

Location: Hyderabad/Bengaluru

Shift Type/Timings: Night Shift-US Healthcare Shifts

Industry Type: BPO/RCM

Role Category: Operations

Job Description: The Senior Process Executive Customer Service (Voice) will be responsible for managing patient inbound calls related to bills, product inquiry, medical billing, claim inquiries, and account resolutions within the RCM process. This role involves handling inbound and outbound calls, addressing queries with accuracy and empathy, and ensuring positive customer experiences while achieving resolution efficiency. The senior executive will also support team performance, mentor junior associates, and drive process improvements.

EssentialDuties and Responsibilities:

Handle inbound and outbound calls to resolve queries related to medical claims, billing, and insurance coverage.

Assist patients on the query related to bills, product inquiry, payment plan.

Investigate and resolve issues related to claim denials, rejections, and patient billing disputes.

Document call outcomes, resolutions, and next actions in the system accurately and timely.

Ensure adherence to SLA and KPI metrics including productivity, quality, first-call resolution, and turnaround time.

Handle escalations professionally and ensure timely closure.

Collaborate with internal Quality, Operations, and Client Teams to streamline issue resolution.

Mentor new hires, share process knowledge, and provide constructive feedback for improvement.

Maintain confidentiality and ensure strict compliance with HIPAA and organizational policies.

Required Skills

Strong understanding of US Healthcare RCM, including AR follow-up, denials, and patient billing.

Excellent verbal communication skills with a clear, neutral accent and professional tone.

Active listening and customer empathy skills for patient or payer interactions.

Strong problem-solving, analytical, and negotiation abilities.

Ability to handle high-volume calls and multitask effectively.

Working knowledge of practice management systems, payer portals, and MS Office tools.

Flexibility to work in US night shifts.

Team player with mentoring and leadership potential.

Qualification

Graduate in any stream (BA/BCOM preferred).

13 years of experience in US Healthcare RCM Voice / Customer Service (AR calling, patient billing, or claim resolution).

Experience in handling escalations, authorization follow-ups, or patient support processes is preferred.