Patient Financial Services Representative

About the role

Koya is looking for resourceful, energetic, and compassionate teammates to fill a critical and integral role within the organization and the patient journey. This candidate will engage extensively with patients via telephone, email, fax, and text/chat. The Patient Financial Services Representative is confident at troubleshooting and will investigate if they do not have enough information to resolve customer complaints and inquiries. Their goal is to provide excellent service and to demonstrate our commitment to customer success with top tier support. This position will report to the Senior Manager, Customer Care. The role is full-time, exempt and will work in a hybrid role in our Dallas, TX location or remote.

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

Skills

• 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

Core Competencies

• 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

Pay

$60,000 - $63,000 USD per year