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

About the role

The PFS Call Center Representative serves as the hospital’s primary contact for all patient billing inquiries, acting as a liaison between Blanchard Valley Health System and patients, providers, and payers for all post-care matters related to account resolution. This role provides information regarding hospital billing practices, policies, and patient billing statements, and assists patients in understanding billing statements to ensure swift resolution of outstanding balances. The position fulfills the organization’s mission of care and service by delivering superior customer service to the patient community.

Responsibilities

• Respond promptly to patient inquiries regarding hospital billing procedures, policies, and statements. Accept inbound phone calls from patients, physician offices, insurance carriers, etc., within a specific response-to-call timeframe, aiming to resolve concerns immediately. Document all patient account activities concisely, including future steps needed for resolution.
• Follow scripts provided by Patient Financial Services/Revenue Cycle Leadership to facilitate consistent and expedient account resolution. Utilize multiple resources to resolve patient inquiries while on the phone, preparing/reviewing billing correspondence, or in person.
• Perform insurance verification to ensure accurate billing and patient balances.
• Negotiate full payment from patients and help them set up agreeable payment plans and/or external payment programs. Collect patient payments made over the counter, over the phone, and by mail daily; properly record all payment types (e.g., cash, check, debit, credit) and transactions into the computer system.
• Understand different payer regulations and communicate effectively with patients regarding their Explanation of Benefits (EOB).
• Handle all cashier functions when needed at the Findlay campus, including registration, financial counseling, and banking requirements. Provide timely and accurate reporting, patient, and associate satisfaction.
• Monitor, complete, and maintain appropriate productivity levels of assigned tasks in accordance with team standards.
• Remain current on collection laws, Medicare/Medicaid laws, HCAP regulations and guidelines, third-party funding requirements, and adhere to all compliance requirements. Maintain a thorough understanding of federal and state regulations and payer-specific policies to promote compliant credit and collection practices. Adhere to HIPAA-related privacy, security, and transaction & code set regulations. Accurately document all account activity.
• Regularly attend and actively participate in staff meetings, in-service, and continuing education programs to stay updated on compliance and organizational changes in the healthcare industry. Assist in other duties and projects as assigned by the supervisor and/or manager.

Requirements

• 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 Windows PC functionality.
• Excellent written and verbal communication with positive-oriented interpersonal skills.
• Ability to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patient served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status. Must interpret the appropriate information needed to identify each patient’s requirements relative to their age-specific needs.

Preferred Qualifications

• Health administrative certification/degree or related field, and/or relevant work experience.
• Previous experience in a call center or “dialer” environment.
• Knowledge of medical terminology, ICD-10, and/or CPT coding.

Physical Demands

This position requires a full range of body motion with intermittent bending, squatting, kneeling, and twisting. The associate must be able to sit for three hours, walk for one hour, and stand for two hours per day. The associate must be able to lift 20 pounds. Excellent eye/hand coordination is required to operate machines. Corrected vision and hearing in the normal range are necessary.