Cust Svc Rep Single Bill Offic / PA Customer Service

Knowledge, Skills and Ability Requirements:

• Outstanding customer service and interpersonal skills.
• Superior communication, organizational, and analytical skills.
• Understanding of Hospital and Professional revenue cycle.
• Ability to work in a high volume setting and respond to patient inquiries in a timely manner.
• Ability to identify and communicate payer and/or system trends.
• Knowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing, collection, and financial assistance procedures.
• Familiar with medical and insurance terminology.
• Proficient in the use of a computer and relevant hospital software applications. 
• Understanding and adherence to HIPPA Regulations and Release of Information Rules.
• Models teamwork through cooperation and collaboration within and outside the work group. 
• Ability to attain productivity and quality standards per department requirements

1. Responds and takes action related to calls, emails, and faxes related to patient billing in a timely and professional manner. Uses a patient-centric approach to answer questions and provide information. Collects patient payments as appropriate.
2. Understands all payer regulations to effectively communicate with patients about charges, payments and adjustments on their account. 
3. Investigates patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc. Works with individuals when appropriate at various levels of the organization to find resolution on patient disputes.
4. Updates account information (addresses, insurances, etc.) and rebills as appropriate to initiate the next steps in the billing and collection cycle.
5. Provides discharge, billing, and other related information to appropriate internal departments or external companies. Attains productivity and quality standards set by the department leadership team.
6. Directs inquiries to appropriate departments if not related to insurance and patient balances. 
7. Responds to customer requests for Pricing Estimates. 
8. Follows all Call Flow steps and strives to meet Average Handle Time, Abandoned Calls, Returned to Queue/Short call and other call center metrics.  Agrees to continuously improve to achieve the highest audit scores possible. Offers MyChart and other new services to patients when applicable. 
9. Works directly with self-pay early-out vendors and collection agencies to address and respond to patient disputes related to billing.
10. Identifies barriers to efficient departmental operations related to self-pay billing and takes an active role in developing appropriate solutions using the H3W model.
11. Representative is willing to learn and actively work in the dispute work queue when necessary, including split shifts between the call team and dispute team.
12. Assists the self-pay follow up team in areas such processing financial assistance applications, preparing patient refund requests, processing bankruptcy notifications, return mail, etc. 

Reports To: Manager, Customer Service