Customer Service Specialist / Revenue Cycle

A Brief Overview

Interacts with customers to answer questions and concerns regarding patient accounts. Maintains a balance between company policy and customer benefit in decision-making. Handles issues in the best interest of both customer and organization.

Essential Functions

• Clarifying the customer’s complaint or inquiry
• Determining the cause of the problem
• Selecting and explaining the best resolution
• Expediting corrections and/or adjustments
• Providing follow-up to ensure resolution or directing to the appropriate area for resolution
• Recording details of inquiries, comments, and complaints, as well as action taken
• Processing patient payments using Epic or Passport, verifying credit/debit card approval
• Aids customers with financial counseling including community resources, setting up payment plans, Medicaid, and/or financial assistance programs
• Utilizes knowledge of billing structures and insurance coverage to guide patients in navigating payment responsibilities and assistance options
• Facilitates effective communication with patients and/or their representatives
• Educates the customer where applicable to prevent the need for future contacts regarding making payments, understanding their benefits, understanding standard billing practices, etc.
• Ensures patient understanding by explaining the components of their billing statement and account activity
• Works with outsource collection agency activity and follow-up; collaborates with patients and parents to resolve issues related to accounts in collection status
• Complies with Federal and State billing requirements
• Also complies with the Health Insurance Portability and Accountability Act (HIPAA) and Electronic Data Interface (EDI) transaction formats

Education Qualifications

• A High School Diploma or GED equivalent
• Required: Associate's Degree in Billing, Coding, or HIM
• PREFERRED: Associate's Degree in Billing, Coding, or HIM

Experience Qualifications

• Minimum of 3-year experience in customer service setting, one of which can be experience working with insurance and/or revenue cycle related processes

Skills And Abilities

• Highly developed sense of integrity and commitment to customer satisfaction
• Demonstrated passion for excellence with respect to treating and caring for customers
• Organized, self-motivated, and able to work independently of direct supervision to carry out responsibilities
• Knowledge of customer services principles and practices
• Knowledge of hospital and professional billing, collection and reimbursement requirements and standard practice
• Ability to review, interpret and understand managed care contracts with third-party payors
• Intermediate computer skills including the use of spreadsheets
• Strong interpersonal skills with attention to detail and ability to organize, interpret, and present data
• Excellent oral and written communication skills and demonstrated ability to communicate with others at all levels
• Ability to perform non-complex arithmetic calculations

Children’s is an equal opportunity employer

Cultivating an inclusive environment of respect and trust where we all belong. We do not discriminate based on race, ethnicity, age, gender identity, religion, disability, veteran status, or any other protected characteristic.