Patient Financial Services Representative

About the role

Koya Medical is a privately held company founded in 2018, dedicated to developing breakthrough treatments for venous diseases and lymphedema to enhance patient mobility and empower self-care. We seek individuals who are curious, passionate, and committed to transforming venous and lymphatic care through innovative, people-centric technologies.

Responsibilities

• Provide insurance and billing related support to customers by phone, text, or email (approximately 80%)
• Complete outgoing Medicare Reinspection calls (approximately 10%)
• Complete Patient Financial Outreach in the case of coverage denial (approximately 10%)
• Educate patients regarding flexible payment options when appropriate
• Take incoming calls from patients to assist with resolving their insurance or billing inquiries and balance payments.
• Follow – and continuously improve – standard procedures
• Build a knowledge base of troubleshooting resolutions
• Work on special projects as needed
• Identify process improvement opportunities and participate in improvement plans
• Maintain working knowledge of Medicare, Medicaid, and commercial insurance plans, including coverage requirements, billing processes, and reimbursement guidelines.

Qualifications

• 5+ years of experience in medical billing, including both inbound and outbound calling
• 2+ years of Customer Service experience
• Associates degree or equivalent
• Demonstrated ability to perform the essential functions as outlined above
• Knowledge and interpretation of insurance, and medical billing processes and documents – including commercial, Medicare, and Medicaid.
• Ability to clearly and effectively communicate in both written and verbal form
• Self-driven with the ability to work independently and accurately
• Excellent communication and customer service skills, including de-escalation tactics.
• Computer proficiencies, including Microsoft office and Salesforce preferred
• Perform common customer service transactions, interactions, and activities.
• Log all customer/patient interactions.
• Ensure compliance with all departmental policies and procedures; adhere to all required health care regulations, security, compliance, and HIPAA policies.
• Ability to handle difficult patient interactions in a professional and timely manner; facilitate the resolution of customer issues by following the escalation process when necessary.

Skills and Abilities

• Organization Skills
• Continuous Improvement
• Problem Solving
• Personal Effectiveness
• Decision Making
• Foster Teamwork
• Ethical Conduct
• Detail Oriented
• Personal Initiative
• Time Management
• Active Listener

Tools and Technology

• NikoHealth
• ConnectPlus
• Microsoft Office Suite
• Adobe
• Salesforce CRM

Physical Functions and Work Environment

• Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.
• The employee is regularly required to talk or hear.
• The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls.
• The employee is occasionally required to stand; walk; sit; and reach with hands and arms.
• The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus.
• The noise level in the work environment is usually low to moderate.

Pay

$60,000 - $63,000 per year

Schedule

This position is full-time, exempt and will work in a hybrid role in our Dallas, TX location or remote.