PATIENT ACCOUNTS CUSTOMER SERVICE REPRESENTATIVE

US:NV:Carson City Patient Financial Services

Per Diem Standard Office Hours

Summary

The Customer Service Representative serves as the hospital's primary contact for all patient billing inquiries. Acts as a liaison between Carson Tahoe Regional Healthcare 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 and details of insurance processing to ensure swift resolution of outstanding balances. Corresponds with insurance providers on behalf of patients to ensure accurate processing of claims as well as verify coverage and policy benefits. Fulfills the organization's mission of care and service by providing superior customer service to the patient community. Complies with State & Federal regulations with regard to billing & collections.

Qualifications

Required

• One (1) year experience in a clerical or customer service role
• One (1) year experience with Microsoft Office (Outlook, Word, Excel)
• Basic knowledge of medical terminology, anatomy/physiology

Preferred

• High school diploma (or equivalent)

• Previous experience in a call center

• Experience with medical billing/collection and healthcare insurance

• Bilingual-Spanish

• Proficient with standard office equipment and PC software

• Experience in a physician office or hospital setting

Essential Functions

• Accepts inbound phone calls from patients, physician offices, insurance carriers, legal offices, etc. within a specific response-to-call time-frame and with the intent to resolve the caller's concern immediately.
• Provides exceptional customer service that aims to improve patient and/or guarantor relations and contribute to a positive work environment
• Responds promptly to patient inquiries via phone call, email, and online portal regarding hospital billing procedures, policies, and statements.
• Clearly explains service charges to patients, reports any charge/payment errors to managerial staff, and resolves any errors.
• Collects patient payments and follows levels of authority for posting adjustments, refunds, and contractual allowances.
• Provides charity applications and screening for financial assistance eligibility.
• Collects insurance information, verify eligibility and benefits and ensure policy information is added correctly
• Collaborates with third party agencies to provide accurate balance information and requested documentation.
• Communicates with legal offices fulfilling billing and balance requests.
• Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB).
• Documents all patient accounts activities concisely, including future steps needed for resolution.
• Interacts effectively with other departments on a daily basis to facilitate patient account resolution.
• Identifies barriers to efficient departmental operations and takes an active role in developing effective solutions.
• Makes outbound phone calls to patients to collect or make arrangements for payment of outstanding balances.
• Facilitates in-person patient inquiries on a walk-in basis during office hours.
• Return all voicemails within 24-48 business hours.
• Completes assigned work queues including obtaining worker's compensation coverage, verifying newborn coverage, distributing patient credits, correcting payment methods, processing deceased accounts, updating payment plan balances, reviewing for surprise billing, and evaluating balances for transfer to a collections agency.
• Processes incoming mail within a timely manner (24 hours).
• Responsibly uses the safe to deposit large bills and sums of money from the cash drawer and keeps the minimum allowable amount in drawer at all times
• Fulfills all incoming fax requests from insurance providers; distributing faxes to their appropriate party when applicable.
• Accurately adds/updates patient demographic data.
• Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA)) as well as facility-specific guidelines.
• Engages in continuous professional development by attending staff meetings, and completing trainings periodically
• Performs other related duties as assigned.