Provides phone and email support for HCFSPlatform customers by troubleshooting application issues, documenting cases, monitoring service-level deadlines, escalating complex matters, maintaining help content, and completing accurate data-entry and vendor reporting tasks. Collaborates with internal teams while protecting confidential information and protected health information. The role is remote-eligible and does not include client training, supervision, or employee performance management.
The Customer Support Specialist develops expertise in the HCFSPlatform and provides timely, accurate, and professional support to customers through phone and email. This role is responsible for troubleshooting issues, maintaining support documentation, completing assigned data-entry responsibilities, and collaborating with internal teams to ensure a positive customer experience.
Key Responsibilities
- Develop and maintain extensive working knowledge of the HCFSPlatform customer workflows, and applicable support procedures.
- Respond to customer support questions and application issues received through phone and email.
- Investigate, document, and resolve customer issues; escalate matters to the appropriate internal teams when additional technical or product expertise is required.
- Maintain thorough, accurate, and up-to-date documentation of all customer interactions, including communications, troubleshooting efforts, resolutions, and required follow-up actions
- Monitor assigned customer support cases and ensure timely updates, follow-up activities, and resolution within established service expectations.
- Identify recurring customer questions or product issues and recommend improvements to support processes, internal documentation, FAQs, and reference materials.
- Maintain and update software help content, release documentation, reference guides, and internal support resources as needed. This responsibility does not include delivering client training.
- Review assigned news articles each business day, evaluate the information for relevance to established business criteria, and accurately enter required data into the designated software system.
- Complete vendor reporting updates related to customer support cases, ensuring required case information, status updates, and resolutions are accurately maintained and submitted within established deadlines.
- Collaborate with Client Engagement, Implementation, IT, and other internal teams to support customer needs and issue resolution.
- Understand and comply with all company Privacy and Security standards.
- Use or disclose protected health information only as permitted or required by law and company policy.
- Handle confidential and sensitive information with ongoing discretion and secure information-management practices.
- Perform other duties as required.
Skills, Knowledge and Expertise
- Proven customer service experience, including resolving customer issues in a professional and timely manner.
- Analytical troubleshooting skills and a structured approach to problem solving.
- Ability to absorb complex technical information and communicate it clearly to users without a technical background.
- Excellent verbal and written communication skills, with strong attention to tone, accuracy, and follow-through.
- Experience working within service-level agreements (SLAs), deadlines, and competing priorities.
- Ability to work effectively under pressure and exercise sound judgment when prioritizing customer needs.
- Strong attention to detail and data-entry accuracy, including the ability to review source articles and consistently capture required information in a software system.
- Advanced knowledge of web-based applications and Microsoft Office products, including Word, Excel, and Outlook.
- Ability to maintain discretion when working with protected health information and other confidential or sensitive information.
- Strong working knowledge of web-based applications; experience in healthcare IT, clinical informatics, or healthcare Fraud, Waste and Abuse (FWA) is preferred.
Role Expectations:
- This position focuses on customer support, issue resolution, accurate documentation, customer communication, and data-entry responsibilities.
- The employee is not responsible for conducting client software training, designing client training programs, analyzing training surveys, supervising employees, assigning work to other staff members, or managing employee performance.
Benefits
- Medical, Dental & Vision insurance
- 401(k) retirement savings with employer match
- Vacation and sick paid time off
- 7 paid holidays & 2 floating holidays
- Paid maternity/paternity leave
- Disability & Life insurance
- Flexible Spending Account (FSA)
- Employee Assistance Program (EAP)
- Free on-site fitness center (for local employees)
- Professional and career development initiatives
- Remote work eligible
Remote Work Requirements
- Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.
Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
About
Healthcare Fraud Shield, headquartered in Chesterfield, MO, is a leading provider of innovative fraud, waste, and abuse (FWA) solutions for healthcare insurance payers. Since its establishment in 2011, the company has focused solely on healthcare fraud prevention and payment integrity, delivering unique advantages to its broad client base. At the heart of Healthcare Fraud Shield's offerings is FWAShield™, an integrated platform designed by industry-leading healthcare experts. This comprehensive solution includes PreShield™ (pre-payment), PostShield™ (post-payment), RxShield™ (pharmacy analytics), CaseShield™ (case management), and QueryShield™ (ad-hoc querying tool). Leveraging the latest technology available, Healthcare Fraud Shield provides the most affordable, flexible, transparent, efficient, and effective solution in the marketplace. With over 20 years of experience, the founders of Healthcare Fraud Shield are pioneers in successful fraud detection software development in the financial services industry. They have designed their suite of software to identify superior FWA rates, utilizing advanced analytics, AI, and the best exterior data. Additionally, Healthcare Fraud Shield offers expert services in detecting and verifying suspected FWA billed services, including the development of claim edit rules. Their experienced SIU team, which includes Accredited Health Care Fraud Investigators and Certified Professional Coders, delivers top-notch training throughout the country. Trust Healthcare Fraud Shield to safeguard your healthcare insurance payments and ensure payment integrity.
Similar Jobs
Information Technology • Software
Provides remote customer assistance through email, phone, chat, and other channels. Responsibilities include answering inquiries, troubleshooting product and account issues, documenting interactions, escalating complex cases, sharing recurring feedback with internal teams, and meeting service-quality and response-time expectations.
Insurance
Respond to customer interactions across phone, chat, SMS, email, and social media. Support policy and billing questions, process transactions and policy changes, resolve payment and account issues, investigate system defects, document interactions accurately, protect customer privacy, and handle escalated concerns while meeting service and performance standards.
Top Skills:
Live ChatMercury Systems And PortalsExcelMicrosoft OutlookMicrosoft WordSmsSocial Media
Legal Tech
Provides phone and ticket-based customer support, resolves client issues, follows escalation workflows, manages competing priorities, and collaborates with Account Management, Scheduling, Billing, and Production teams. The role requires clear communication, composure under pressure, remote-work readiness, and accurate use of Zendesk, Slack, and Guru. Schedule is Monday through Friday, 10:30 a.m. to 7 p.m. Pacific Time.
Top Skills:
GuruSlackZendesk
What you need to know about the Colorado Tech Scene
With a business-friendly climate and research universities like CU Boulder and Colorado State, Colorado has made a name for itself as a startup ecosystem. The state boasts a skilled workforce and high quality of life thanks to its affordable housing, vibrant cultural scene and unparalleled opportunities for outdoor recreation. Colorado is also home to the National Renewable Energy Laboratory, helping cement its status as a hub for renewable energy innovation.
Key Facts About Colorado Tech
- Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
- Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
- Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
- Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute
