Customer Service Representative I Full Time

Sparta, TN - USA

Monthly Salary: Not Disclosed

Posted on: 10 hours ago

Vacancies: 1 Vacancy

Job Summary

Position Summary:

Customer Service Representative I serve as the first point of contact for the customer service issues and resolves a high volume of patient inquiries regarding both hospital and professional billing questions.

Essential Job Functions:

Delivers an exceptional Patient Financial experience by receiving and directing the public by telephone or other electronic means in a professional and courteous manner and with consciousness and sensitivity to the diversity of the organization and its patients needs.
Manages a high volume of inbound calls answers patient inquiries and determines the appropriate path for resolution and follow-up.
Demonstrates excellent customer service and expertise to patients guarantors and other external and internal contacts through oral and written communication.
Responds to and documents all patient and internal inquiries regarding hospital and professional visits in the patient billing platform as they relate to the patient financial experience.
Understands varying business processes and procedures of both the Physician Billing Office and Hospital Billing Office and is able to evaluate the most appropriate route for account resolution.
Reads interprets and understands various differing insurance correspondence including both explanation and coordination of benefits.
Demonstrates a basic understanding of varying different reimbursement terms across multiple payers and benefit plan types (HMO PPO Indemnity HDHP) in both the Physician Billing and Hospital Billing landscape and how those terms may affect the responsible partys benefits and subsequent balance(s).
Demonstrates a basic understanding of the standard healthcare coding methodologies including but not limited to CPT HCPCS and ICD-10.
Performs all clerical functions required to complete a request using available information and resources. Coordinates to resolve issues requiring follow-up with the appropriate team insurance companies attorneys offices and other departments.
Performs appropriate updates to insurance coverage demographic information and contact information in patient billing system.
Performs analysis of the responsible partys outstanding balance and provides consultative services to establish the most efficient and effective account resolution that meets the needs of the patient while also protecting the financial viability of Alleghany Health.
Prompts guarantors to pay outstanding balances over the phone using a credit or debit card provides the lockbox mailing address for physical checks or initiates monthly payment arrangements for patients through Advocate Healths third-party partner.
Responsible for meeting and maintaining Productivity measures and Quality Assurance goals as established by the Customer Service Department.

PROFESSIONAL REQUIREMENTS:

Qualifications:

* Education/Experience Requirements: High School Diploma or GED with 2 years relevant customer service experience or bachelors degree preferred. 2 years progressive work experience in a hospital billing professional billing or shared services environment preferred. Experience with Epics Resolute Hospital or Resolute Professional billing applications preferred. Working knowledge or professional and hospital billing and follow-up preferred. Knowledge of HIPAA standards and medical terminology and billing practices preferred. Bi-lingual (Spanish and English) preferred.

* Licensure/Certification Requirements: None

Physical Demands:

Work requires most of the time spent sitting however the work does require some walking. Work requires heavy telephone use and interaction with patients family members other departments and outside sources. Requires minimal standing to file documents and do research. Must be able to reach and bend on a moderate level.

Compliance: Alleghany Health is strongly committed to our compliance program. The employee will follow and understand all sections of AHs Ethics and Compliance Program Manual as it applies to their position. The employee will follow all compliance performance standards as directed by their Manager Director and Compliance Officer. The employee is responsible for detecting compliance concerns related to their employment and report any such concerns to their Manager Director or Compliance Officer

Required Experience:

Unclear Seniority

Position Summary: Customer Service Representative I serve as the first point of contact for the customer service issues and resolves a high volume of patient inquiries regarding both hospital and professional billing questions.Essential Job Functions: Delivers an exceptional Patient Financial experi...

Position Summary:

Essential Job Functions:

Delivers an exceptional Patient Financial experience by receiving and directing the public by telephone or other electronic means in a professional and courteous manner and with consciousness and sensitivity to the diversity of the organization and its patients needs.
Manages a high volume of inbound calls answers patient inquiries and determines the appropriate path for resolution and follow-up.
Demonstrates excellent customer service and expertise to patients guarantors and other external and internal contacts through oral and written communication.
Responds to and documents all patient and internal inquiries regarding hospital and professional visits in the patient billing platform as they relate to the patient financial experience.
Understands varying business processes and procedures of both the Physician Billing Office and Hospital Billing Office and is able to evaluate the most appropriate route for account resolution.
Reads interprets and understands various differing insurance correspondence including both explanation and coordination of benefits.
Demonstrates a basic understanding of varying different reimbursement terms across multiple payers and benefit plan types (HMO PPO Indemnity HDHP) in both the Physician Billing and Hospital Billing landscape and how those terms may affect the responsible partys benefits and subsequent balance(s).
Demonstrates a basic understanding of the standard healthcare coding methodologies including but not limited to CPT HCPCS and ICD-10.
Performs all clerical functions required to complete a request using available information and resources. Coordinates to resolve issues requiring follow-up with the appropriate team insurance companies attorneys offices and other departments.
Performs appropriate updates to insurance coverage demographic information and contact information in patient billing system.
Performs analysis of the responsible partys outstanding balance and provides consultative services to establish the most efficient and effective account resolution that meets the needs of the patient while also protecting the financial viability of Alleghany Health.
Prompts guarantors to pay outstanding balances over the phone using a credit or debit card provides the lockbox mailing address for physical checks or initiates monthly payment arrangements for patients through Advocate Healths third-party partner.
Responsible for meeting and maintaining Productivity measures and Quality Assurance goals as established by the Customer Service Department.