Patient Financial Services Customer Service Representative

Fairview is seeking a full-time, benefit-eligible Patient Financial Services Customer Service Representative to join our team. In this role, you will provide exceptional customer service by assisting patients with billing, payment, and insurance-related inquiries while supporting a collaborative Revenue Cycle team. This position offers the opportunity to perform your work in a flexible virtual environment while collaborating closely with the Revenue Cycle team 

This position is responsible for providing Fairview patients with an understanding of the billing and insurance processing of their healthcare services through the inbound call center. The CSC Representative will counsel patients on financial solutions available to them either through direct payments, payment plans, or screening for qualification for assistance programs. The CSC Representative will manage both hospital and physician accounts in all systems and understand in depth the Registration, Hospital Billing, and Clinic Billing functions that are necessary to resolve accounts. They will also be well-versed in collection practices, understanding of the Attorney General Requirements, and able to liaison with bad debt vendors when needed. They will have detailed knowledge of the functions within the Revenue Cycle and how they interact in the life of a patient account. 

Responsibilities

• Maintains the best practice routine per department guidelines:
• Handle calls presented to CSC through the automated call distribution system accurately and efficiently.
• Work independently in problem solving with patients regarding their accounts in both hospital and clinic billing situations. Counsel the patient on the complexity of the interdependency between hospital and physician billing within the patient’s continuity of care.
• Able to handle each call with compassion, service, dignity and integrity in mind as aligned with MHealth Fairview's values
• Timely processing of patient/insurance requests for follow-up of payment research, checking charges, coding review, insurance processing concerns, etc.
• Identifies when callers need to be referred to insurance specialist or escalation staff for further assistance.
• Notifies patient and/or guarantor of self-pay balances co-pays/deductible/coinsurance, etc.
• Understands and adheres to Revenue Cycle’s Escalation Policy.
• Contributes to the process or enablement of collection of expected payment.
• Meet department goals and maintain productivity while working remotely.
• Manage accuracy of accounts to ensure appropriate billing and compliance with patient privacy and data integrity:
• Timely and accurate work
• Verifies insurance benefits to maximize reimbursement.
• Assists customers regarding billing questions and ensures appropriate resolution of problems. Explain and interpret eligibility rules and regulations or identify other resources available for financial assistance. Identify patients who may be eligible for financial exceptions. Keep updated on changes with regulatory issues.
• Validate patient data is accurate and authorization is in place to provide information.
• Uninsured accounts reviewed and managed to include validation that uninsured discounts have been appropriately applied, and all payment sources available to the patient have been explored.
• Bad debt management of accounts and interactions with vendors.
• Counsel patients throughout the collection process on solutions available to them for account resolution.
• Problem solves with vendors and patients on reasonable resolutions.
• Identify patients with financial need.

Required Qualifications

• 2 years customer service experience
• This individual should have strong interest in learning new IS systems (PASS, Deloitte overlay system, Healthworks, etc) as well as the ability to work independently

Preferred Qualifications

• Associate of Arts
• 2 years in healthcare customer service
• 3 years experience in a hospital or clinic business office
• Previous call center experience