RCM Customer Service Representative

Who We Are

ABOUT ENOVIS™

Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit www.enovis.com.

What You'll Do

The Patient Services Representative III serves as a senior member of the Patient Services team, providing advanced case management and customer support to patients, healthcare providers, and insurance carriers. This role acts as a subject matter expert for complex patient cases, escalated customer service concerns, insurance benefit interpretation, product quality troubleshooting and reimbursement support. The representative independently manages challenging situations, mentors team members, identifies process improvements, and serves as a key resource across multiple departments.

This position requires exceptional communication skills, strong leadership capabilities, bilingual fluency in English and Spanish, required to work East Coast business hours from Monday through Friday, 5:00 AM PST to 2:00 PM PST.

Patient Support & Case Management

• Manage complex patient cases from initiation through resolution while ensuring a high standard of patient care and service.
• Serve as the primary point of contact for escalated patient, provider, and payer inquiries.
• Communicate detailed and technically complex benefit, insurance, reimbursement, and therapy-related information to patients and healthcare providers.
• Interpret and explain medical, insurance, and reimbursement information in a clear and understandable manner.
• Support Regen quality patient calls and troubleshooting.

Escalation Management

• Resolve advanced customer service issues and complex reimbursement challenges with minimal supervision.
• Investigate and address patient complaints, service concerns, and operational issues while ensuring timely resolution.
• Act as a resource for handling sensitive, high-priority, or critical patient situations.
• Exercise sound judgment when deviating from established procedures to achieve optimal patient outcomes.

Leadership & Team Support

• Serve as a mentor and resource for Patient Services Representatives I and II.
• Assist with onboarding, training, and knowledge-sharing initiatives.
• Provide guidance on complex cases, insurance benefit interpretation, and escalation management.
• Lead by example by demonstrating accountability, professionalism, and exceptional customer service.
• Support supervisors and management with departmental projects, reporting, and process improvement initiatives.

Cross-Functional Collaboration

• Partner with Sales, Information Technology, Service, Manufacturing, and other departments to ensure seamless patient support.
• Communicate trends, recurring issues, and opportunities for process improvement to leadership.
• Participate in testing, workflow enhancement, and operational improvement projects.
• Support implementation of new programs, services, and departmental initiatives.

Operational Excellence

• Maintain detailed and accurate documentation in required systems.
• Monitor case progress and proactively follow up to ensure timely completion.
• Identify workflow inefficiencies and recommend improvements to enhance the patient experience.
• Consistently meet or exceed quality, productivity, service level, and compliance expectations.

REQUIREMENTS: EXPERIENCE, EDUCATION, SKILLS, AND KNOWLEDGE

• High school diploma or equivalent required; associate's or bachelor's degree preferred.
• Minimum of 3-5 years of customer service, patient services, reimbursement, healthcare support, or related experience.
• Minimum of 2-3 years of bilingual voice experience (English and Spanish) in a healthcare, patient support, call center, or customer service environment.
• Demonstrated experience managing escalated customer service situations and complex patient cases.
• Proven ability to work independently with limited supervision.
• Strong leadership, coaching, and mentoring skills.
• Ability to effectively communicate with patients, physicians, insurance carriers, and internal stakeholders.
• Advanced verbal and written communication skills in both English and Spanish.
• Strong organizational, analytical, and problem-solving abilities.
• Proficiency with customer relationship management systems, patient management tools, and Microsoft Office applications.
• Fluent bilingual proficiency in English and Spanish.
• Skilled leader and self-starter with the ability to prioritize and manage competing responsibilities.
• Advanced understanding of healthcare reimbursement and insurance benefit structures.
• Ability to independently assess situations and make informed decisions.
• Strong conflict resolution and de-escalation skills.
• Excellent attention to detail and commitment to patient satisfaction.

EQUAL EMPLOYMENT OPPORTUNITY
Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees’ beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis.