Patient Account Rep JP5474

Max PAY RATE $28.50 Responsible for performing customer care activities in accordance with applicable Federal, State and local standards, guidelines and regulations. These responsibilities include but are not limited to customer service, billing and/or patient account balance collection activities associated with the hospital and professional revenue cycle. Responsible for providing excellent customer service to patients seeking information from the business office and general administrative duties related to patient billing that will facilitate improved revenue. The Specialist handles a high volume of inbound and outbound calls and must operate with a high level of professionalism. The Customer Service Resolution Specialist is knowledgeable in the full scope of medical billing and is empowered to make decisions independently regarding patient financial responsibilities in accordance with departmental policies. The individual exerts a strong ability to deal with difficult customers, and has ability to deescalate callers to enhance the productiveness of the call and increase customer service quality, while finding resolution to the callers concern. The Customer Service Resolution Specialist will mainly utilize the Epic application. This application is used to house the patients electronic medical record, including information regarding appointments, demographics, and patient billing information. The Specialist is knowledgeable within multiple registration and billing applications and will navigate across multiple applications during the duration of a call to troubleshoot an account. The Specialist has the ability to identify any workflow or process discrepancies within the invoice and can communicate them effectively to leadership team. Essential Functions The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patients rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. Employee must perform all duties and responsibilities in accordance with the CICARE Standards of the Hospital. CICARE is the foundation of Stanfords patientexperience and represents a framework for patientcentered interactions. Inbound & Outbound Calls Customer Service Resolution Specialist are responsible for receiving all incoming calls on the ACD (Automated Call Distribution) telephone system. Perform timely and efficient collection of all PB and HB selfpay balances. The Specialist makes outbound calls to patients with selfpay accounts balances that are due for payment. Evaluates the financial situation of the patient being insured vs uninsured. Arranging a method of payment for services rendered, the Specialist works within the financial limitations the patient may have. After determining the income, debts and insurance coverage of a patient, the Specialist communicates the SHC policies and procedures with regards to payment or financial assistance. Registration and Demographic Updates Update patient demographic or insurance information. Has the knowledge and ability to verify eligibility and bill claims to updated health plan. Account Inquiry Identify and confirm balances that are patient responsibility and advise patient accordingly. If patient has a dispute or patient complaint the Specialist has the ability and knowledge to handle these types of patient concerns and notifies area Manager if needed. Identifies discrepancies with payments or adjustments within an invoice and the ability to discuss the account with the patient. May offer and create payment plans with patients regarding their balances, if applicable. Ability to obtain patient payment over the telephone. Contacts and notifies health plans as needed for follow up to patient contact. Work is performed in accordance with established schedules and procedures, however employees are expected to prioritize assignments, adjust schedules or alter sequence of steps as necessary to obtain desired result. Ability to identify problems and seek solutions using appropriate resources. Identifies appropriate areas for professional growth and attends continuing education classes throughout the year Performs or requests adjustments and contractual write offs as applicable Maintains a thorough understanding of hospital and professional billing procedures and payment practices of state, federal and all third party payers. Resolves HB and PB customer service inquiries which could include: Benefit and eligibility information Billing and payment issues Authorization for treatment Explanation of benefits (EOB) Perform timely and efficient collection of all HB and PB selfpay balances by calling patients/guarantors and others to collect or arrange budget plan options and resolve issues. Performs presumptive charity determinations as applicable. Performs bad debt request transfers as applicable. Ensures daily productivity standards of assigned accounts are met and posting of all action codes related to patients accounts Maintains a thorough, practical understanding of departmental established policies and procedures Participates in organization or department projects as assigned Other duties as assigned Minimum Requirements Education: High School diploma or GED equivalent Experience: Three (3) years of progressively responsible and experience in healthcare setting, with physician practice or facility/outpatient setting is preferred License/Certification: HFMA Certified Revenue Cycle Representative (CRCR) certification preferred. Knowledge, Skills, and Abilities These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification. Government/nongovernment payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities Medical terminology, CPT4, ICD9, HCPCS, modifier coding and how these items drive reimbursement Knowledge of Medicare, MediCal, commercial and managed care insurance preferred Strong computer skills including experience working with the following: Microsoft Office Suite (Word, Excel, PowerPoint), electronic calendar and email Ability to work independently with attention to detail and excellent followthrough while maintaintaining confidentiality as required Demonstrated ability to access state and federal websites for coding, billing and reimbursement information Principles and practices of customer service and telephone courtesy Organizational, planning, analytical and problem solving skills Demonstrated verbal and written communication skills Epic Professional Billing, Hospital Billing, or Single Billing Office experience preferred

  • Apply with Adecco

Reference number US_EN_99_025110_11917397