Customer Service Representative I, Part Time

Mass General Brigham is a not-for-profit organization that supports patient care, research, teaching, and community service. They are seeking Remote Customer Service Representatives to review and resolve guarantor account balances, focusing on providing excellent customer service to enhance the overall experience.

Responsibilities:

• Respond to patient/guarantor/Customer concerns which span a wide range of issues including payer denials, coding accuracy/appropriateness, secondary billing, Coordination of Benefits, verification of co-payments/co-insurance/deductibles and verification/updates to demographic/insurance information and fiscal registrations to verify the patient’s responsibility for all outstanding balances
• Verification process routinely includes contacting other departments at MGB/RCO/entities, payers, affiliated physician organizations and other vendors (Collection Agencies and other outsource agents)
• Credit & Collection Policy and Financial Assistance Policy and must inform patients of all assistance available to them when making payment arrangements, processing payments, application, or referring patients to Financial Counseling
• Provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries
• Whenever possible, resolve issues during the initial telephone call
• Verify the patient’s fiscal and demographic information at every opportunity and make appropriate updates to various billing systems to ensure claims are processed appropriately and Medicare as a Secondary Payer questionnaire
• Resolve complex issues with minimal external or supervisory involvement
• Document all patient interactions and account actions in assigned billing systems to establish a clear audit trail
• Obtain information from and perform actions on accounts in Epic (HB and PB Resolute) and for selected HB accounts, TRAC and QUIC
• Look up information in other support systems as needed including, but not limited to, Legacy Data Access LDA, document imaging (OnBase), eligibility verification systems (NEHEN, payer web sites) and other document backup (Sharepoint) to identify root cause issues
• Use systems and information to resolve issues and respond to the patient’s inquiry
• Obtain information from internal third-party payer units, intermediaries for professional practices and hospital departments, payers, ambulance companies and other hospitals/Home Health/Rehab Facilities to help resolve the patient’s inquiry
• Understand liability claims, legal basics, medical terminology, a general knowledge of the MGB Network hospitals including major variations in administrative protocols as well as key industry issues
• Must provide cordial, courteous and high-quality service to callers
• Must listens attentively to patients by placing customer concerns ahead of oneself
• Understand and practice concern for patients as the ultimate consumers of service
• Effectively handle all communications, which may include via Work Queues, correspondence, telephone and emails (MGB emails and Patient Gateway/Epic Inbox messages, from patients and other departments within MGB)
• Utilize customer service, collections, and billing experience to gather and interpret relevant information to resolve patient account issues and complaints
• Follow through on commitments and achieves desired results
• Exhibits sound judgment, obtains the facts, examines options, gains support and achieves positive outcomes

Requirements:

• High School diploma or GED equivalent required
• Effective communication, organizational and problem-solving skills required
• 1-3 years relevant experience in customer service or collections in a health care setting strongly preferred
• Diligent in following HIPAA Privacy guidelines
• Ability to respond knowledgeably to a wide range of issues for every contracted and non-contracted payer
• Ability to provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries
• Ability to effectively handle all communications, which may include via Work Queues, correspondence, telephone and emails
• Ability to document all patient interactions and account actions in assigned billing systems
• Ability to communicate clearly and concisely both orally and in writing
• Ability to maintain high standards of professional conduct
• Ability to comply with all applicable MGB Patient Billing Solution policies and procedures
• Ability to follow department attendance expectations and arrive for work well prepared at the expected time
• Associates Degree preferred
• Epic billing systems knowledge preferred
• Alternative work experience or training in lieu of experience may be considered