Customer Service Specialist

Advocate Aurora Health is the third-largest nonprofit, integrated health system in the United States, providing care to nearly 6 million patients. They are seeking a Customer Service Specialist who will assess incoming calls, provide direction to team members, and maintain compliance with regulations while ensuring high-quality customer service.

Responsibilities:

• Assesses the nature of incoming calls, identifies, and completes appropriate action in a prompt manner
• Activities may include, researching specific transactions on a claim, re-sending patient statement, re-billing a claim, adding or changing insurance information, verifying eligibility on account, pulling an explanation of insurance benefits for payment information, requesting an adjustment on a claim, sending itemized statements, sending a Financial Aid Application to a patient or referring to Financial Counseling, as appropriate, and directing customer to the appropriate responsible party to resolve concerns outside PFS, as needed, and posting comment(s) into Epic documenting patient’s concern and the actions taken
• Provides direction to the other members of the team, serves as a resource for questions
• Researches the more difficult accounts and questions
• Prioritizes the workload based on guidance from management
• Organizes work/resources to accomplish objectives and meet deadlines
• Understands all key processes in PFS including activities related to billing, collections/follow-up, posting and customer service and how their actions impact the Revenue Cycle
• Assists in the development of training materials
• Maintains compliance with federal, state and local regulations, HIPAA and the Corporate Responsibility Program
• Maintains the privacy and security of all confidential and protected health information
• Reports issues and trends to appropriate management personnel in PFS and works collaboratively to develop solutions
• Participates in all educational activities and demonstrates personal responsibility for job performance
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations
• Maintains satisfactory attendance and punctuality record as set forth by Wake Forest Baptist Medical Center policies
• Performs other relevant work functions, as requested

Requirements:

• High school diploma or GED equivalent and two years of customer service experience
• Excellent phone etiquette and internal/external customer service skills required to interact with patient accounting personnel on a daily basis concerning patient issues
• Demonstrates the ability to work independently
• Consistently demonstrates a positive and professional attitude at work
• Maintains stable performance under pressure
• Handles stress in ways to maintain relationships with patients, customers and co-workers
• Ability to communicate effectively both orally and in writing
• Strong computer and math skills, knowledge of Excel is required
• Demonstrates leadership in establishing and achieving goals
• Extensive knowledge of Medicare, Medicaid and all other third party insurance guidelines
• Ability to exercise independent judgment in unusual or stressful situations
• Demonstrates in-depth knowledge and experience in the following technology solutions: patient accounting, optical imaging and scanning, patient systems and internet-based insurance websites
• Two years business office experience in a physician practice or hospital preferred