Customer Service Specialist / Revenue Cycle

Full-time, Monday through Friday, 8:00 am – 5:00 pm.

About the role

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. Must be able to review and interpret both hospital and professional fee billing, including Explanation of Benefits (EOBs), charges, adjustments, and payments to accurately assist patients.

Responsibilities

• 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
• Assisting customers with financial counseling including community resources, setting up payment plans, Medicaid, and/or financial assistance programs
• Utilizing knowledge of billing structures and insurance coverage to guide patients in navigating payment responsibilities and assistance options
• Facilitating effective communication with patients and/or their representatives
• Educating the customer where applicable to prevent the need for future contacts regarding making payments, understanding their benefits, understanding standard billing practices, etc.
• Ensuring patient understanding by explaining the components of their billing statement and account activity
• Working with outsource collection agency activity and follow-up; collaborating with patients and parents to resolve issues related to accounts in collection status
• Complying with Federal and State billing requirements, the Health Insurance Portability and Accountability Act (HIPAA), and Electronic Data Interface (EDI) transaction formats

Requirements

• High School Diploma or GED equivalent (required)
• Associate's Degree in Billing, Coding, or HIM (preferred)
• 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

• 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