Customer Experience Representative

Position Overview We are seeking a Customer Experience Representative dedicated to delivering exceptional patient care and streamlined operational support. In this role, you will serve as the primary point of contact for our patients, facilitating seamless intake, scheduling, and ongoing communication with physical therapy clinicians. You will manage physical therapy insurance verifications, coverage determinations, and pre-authorization workflows to ensure continuity of care across every stage of the patient journey. Core Responsibilities Patient Engagement & Intake: Serve as the initial point of contact for onboarding and scheduling, ensuring a high-touch, empathetic patient experience. Clinical & Care Team Liaison: Facilitate cross-functional communication between patients and Physical Therapists (PTs), managing schedule updates, documentation requests, and care coordination. Insurance Verification & Compliance: Perform detailed benefit verifications—including evaluating visit caps, co-pays, deductibles, co-insurance, and payer-specific authorization policies. Omnichannel Inquiry Resolution: Respond promptly to patient inquiries via phone, email, and chat regarding billing, insurance coverage, and appointment scheduling, maintaining a high first-contact resolution rate. Documentation & Data Integrity: Maintain precise, detailed records of patient interactions, support tickets, and case resolutions within internal software systems. Process Improvement & Escalations: Identify recurring operational bottlenecks or patient feedback trends and escalate findings to leadership to inform continuous service improvements. Cross-Functional Collaboration: Partner directly with Scheduling, Revenue Cycle Management (RCM), and Clinical Operations teams to prevent delays or disruptions in patient care. Policy Knowledge & Performance Metrics: Maintain up-to-date knowledge of organization offerings and health plan policies while meeting or exceeding key performance indicators (KPIs) for response and resolution times.

Qualifications

Required 3+ years of experience within an outpatient rehabilitation clinic, physical therapy practice, or specialized healthcare setting. Direct expertise in PT benefit verification, including navigating visit caps, therapy caps (PT/OT/ST), co-insurance structures, and deductibles. Proven track record in insurance authorization management, including submitting, tracking, and proactively renewing coverage approvals. Strong interpersonal and communication skills, with a demonstrated ability to resolve complex patient inquiries with professionalism and tact. High attention to detail, with the ability to prioritize and execute multiple support tickets and active patient cases simultaneously. Proficiency in written communication, ensuring clear internal ticketing notes and professional patient communications. Familiarity with ticketing systems or customer support management platforms. Preferred Hands-on experience with Zendesk or equivalent enterprise ticketing software. Knowledge of Medicare regulations and commercial payer policies specific to physical therapy documentation standards and clinical holds. Prior experience collaborating with Revenue Cycle Management (RCM), billing, and clinical teams. Bilingual capability (verbal and written). Key Success Indicators Accuracy & Timeliness: Timely, error-free insurance verifications that eliminate billing errors and scheduling delays. Proactive Authorization Management: Early identification of authorization renewals to guarantee uninterrupted care. Patient Satisfaction: High First-Contact Resolution (FCR) rates and strong patient satisfaction scores. Audit-Ready Documentation: Accurate, well-organized ticket histories and patient logs across all communication channels. Team Alignment: Collaborative cross-departmental workflows that streamline operations and enhance overall service delivery.