Customer Service Representative - OR

The Customer Service Representative – Level 1 is responsible for handling customer telephone calls, both incoming and out-going.  Incumbent is responsible for establishing the means by which an account will be paid, by either billing the patient, a third party payor (insurance), or recommending the account be assigned to an outside collection agency.

DUTIES:          

Managerial

Manage own time and work assignments effectively.

Seek advice/feedback in terms of priorities when necessary.

Technical

Answer incoming customer service telephone calls and take appropriate action to resolve accounts.

Answer questions, process information obtained from patients and process customer complaints by giving information to the appropriate person.

Review and process customer accounts within multiple Accounts Receivable Billing Systems, (e.g. AmbPac, AmBillz, JAGUAR, and AM2000).

Input information obtained and enter notes relating to an account into Accounts Receivable Billing System, as needed.

Edit and release accounts for billing.

Call insurance company or third party to obtain billing information and/or to check claim status or eligibility.   

Assist walk-in patients with account issues and complaint resolution.

Work private pay patient correspondence and internal private pay projects.

Resolve past-due or delinquent accounts (collections).   

Perform other duties as required.

Interpersonal

Work in a spirit of teamwork and cooperation.

Convey a sense of competence and commitment.

Use initiative to learn new skills, enhance personal knowledge and improve communications.

Demonstrate an ability to work well with team members.

Communicate a willingness to help others succeed.

Share workspace and resources as necessary.

Knowledge

Medical transportation processes.

Language and terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet.

Medical and insurance terminology.

Understand the process of signature and paperwork compliance.

Payor-specific requirements for one or more geographical areas.

Definitions of and distinctions between ALS/BLS/SCT/CCT/Wheelchair levels of service.

ICD-9 coding/condition codes and procedure codes.

HIPAA requirements.

Skills

Internet tools, (e.g. Internet mapping programs, eligibility websites, address search engines, credit card processing programs). 

Proficiency in multiple Accounts Receivable Billing Systems, (e.g. AmbPac, AmBillz, JAGUAR, and AM2000).

Communicate effectively, (both orally and in writing) in English.

Effectively handle complex customer issues.

Handle emotional callers with sensitivity and provide calming and objective resolutions.

Abilities

Pass and sustain new-hire and department-specific testing, (e.g. data entry and department-specific aptitude test).

Be flexible with shifting daily priorities.

Meet deadlines working within tight time constraints.

Handle a large volume of work and telephone calls.

Meet or exceed all established standards for productivity and quality.