PFS Call Center Representative - 40 hrs/wk, 1st shift

Purpose of this Position

The PFS Call Center Representative serves as the hospital’s primary contact for all patient billing inquiries. Acts as a liaison between Blanchard Valley Health System and patients, providers, and payers for all post-care matters related to account resolution. Provides information regarding hospital billing practices, policies, and patient billing statements. Assists patients in understanding billing statements to ensure swift resolution of outstanding balances.

Job Duties/Responsibilities

• Responds promptly to patient inquiries regarding hospital billing procedures, policies, and statements. Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. within a specific response-to-call timeframe and with the intent to resolve the caller’s concern immediately. Documents all patient accounts activities concisely, including future steps needed for resolution.
• Fulfills insurance verification resulting in accurate billing and patient balances. Negotiates full payment from patients and helps them set up an agreeable payment plan and/or external payment program. Collects patient payments made over the counter, over the phone, and by mail daily; properly records all payment types (e.g., cash, check, debit, credit) and transactions into the computer system.
• Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB).
• Responsible for all cashier functions when needed at the Findlay campus. Including registration, financial counseling, and banking requirements. Provides timely and accurate reporting, patient, and associate satisfaction.
• Maintains a thorough understanding and education of federal and state regulations and payer specific policies and requirements to promote compliant credit and collection practices. Accurately documents all account activity.
• Remains current on collection laws, Medicare/Medicaid laws, HCAP regulations and guidelines, third party funding requirements, and adheres to all requirements for compliance.
• Regularly attends and actively participates in staff meetings, in-service, and continuing education programs as offered.
• Assists in other duties and projects as needed assigned by the supervisor and/or manager.

Required Qualifications

• High school graduate or GED equivalent
• 2-3 years of experience in medical billing and collections, or satisfactory completion of internal billing/self-pay billing assessment
• Certified Patient Financial Services Specialist certificate to be completed within 12 months of hire date
• Knowledge and experience with Microsoft office products and Window PC functionality
• Excellent written and verbal communication with positive oriented interpersonal skills
• Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department

Preferred Qualifications

• Health administrative certification/degree or related field, and/or relevant work experience
• Previous experience in a call center or “dialer” environment
• Medical terminology
• IDC 10 and/or CPT coding knowledge