Customer Service Specialist

JOB SUMMARY:

Under the direction of the Billing Supervisor, performs the insurance billing and follow up related to guarantor accounts, including patient inquiry, guarantor balance resolution, account correction, and patient collections Exhibits the F.I.R.S.T. values (Friendliness, Innovation, Respect, Service, and Trust).

 

ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

• Performs functions within a call center format addressing patient questions, complaints, inquiry, collection of payment.
• Responds to written inquiry from patients, authorized persons, law office/s, and other entities authorized to speak on patient accounts.
• Complete communications between organization vendors in regards to patient accounts and other inquiries.
• Reviews all billing claims for accuracy of charges and appropriate billing edits.
• Maintains a working knowledge of billing requirements for all payers and makes the needed corrections to the claims prior to billing.
• Demonstrates the ability to maneuver around the websites associated with your designated payer to check eligibility and claim status and stays current with any ongoing changes.
• Resolve patient questions associate to billing and collections.
• Documentation and escalation of accounts if/when appropriate.
• Collection of patient payments via telephony services.
• Effectively documents all inquiries, conversations, actions performed, complaints, and any other action performed during patient communication.
• Respond to organizational inquiry email and mailed patient correspondence.
• Meet and maintain quality standards established by the department.
•  
• Provide accurate and timely information to patients regarding outstanding balances, insurance benefits, eligibility, and other associated requests.

• Being courteous and respectful at all times to patients and associates throughout the organization by demonstrating the F.I.R.S.T. Values at all times.
• Demonstrates a commitment to professional accountability and growth to maintain and expand knowledge and skills.
• Contributes to the achievement of the mission and philosophy of the Organization.
• Contributes to the effective operations of the Organization by demonstrating dependability in job performance.
• Demonstrates a commitment to incorporating the core concepts of patient family centered care into practice (dignity, respect, information sharing, and participation).
• Demonstrates a commitment to the development and implementation of shared governance across the Organization.
• Performs other related duties as assigned.

WORKING CONDITIONS, HAZARDS AND PHYSICAL EFFORT:

Average work station area with normal levels of noise. Minimal physical exertion. Must be able to work with constant interruptions. The task of this job does not involve exposure to blood, body fluids, or tissue. Must be able to move or position 25 lbs. independently.

 

CONTACTS WITH OTHERS:

Contact with most all Ephraim McDowell Health Associates, patients, visitors, insurance carriers, physicians' offices staff and collection agencies.

 

EQUIPMENT USED/SPECIAL SKILLS REQUIRED:

Standard office equipment, Microsoft Office and G-Suite. Excellent communication skills. In-depth knowledge of third-party payer benefits required.

 

Qualifications

Two (2) years of experience in A/R follow-up, insurance billing, or related healthcare billing services OR Associates degree and One (1) year of relevant experience OR Four (4) year degree in healthcare or business-related field.