Billing Customer Service Representative – Call Center (1.0 FTE)

1. Project a positive and helpful demeanor while working with patients, visitors, and staff.
2. Collect appropriate deposit, deductible and/or co-insurance amounts from patient/guarantor at pre-admit, admit, in house or at discharge.
3. Complete insured and uninsured patient estimates upon request.
4. Evaluate guarantor financial status, previous account information, eligibility tools, employment history, and all other income verification documentation, to determine the most feasible method of payment.
5. Gather and assess financial data to help determine patient eligibility for Medicaid, SSI, charity and other financial assistance programs while working cohesively with associated vendors (Such as a Medical Advocate).
6. Responsible for timely documentation of all pertinent information on the patient account.
7. Responsible for evaluating, tracking, and logging all patient assistance applications and HIPAA release of information forms
8. Maintain knowledge of resources available both inside St Peter’s and outside agencies to aid with patient issues.
9. Handle all incoming customer service questions to identify needs and issues.  Including but not limited to charge explanation, relaying/explaining insurance activity, offering patient assistance and setting up payment plans.
10. Makes outbound calls to set up payment arrangements and follow up on delinquent accounts.
11. Manages accounts needing to be transferred to outside collections agencies
12. Processes patient correspondence, queries and disputes from our collection agencies
13. When needed with go to court proceedings to represent the hospital in collections of debts.
14. Maintain compliance with state and federal regulations as they relate to Patient Financial Services.
15. Responds to all Smart Sheet items assigned to them within 2-7 business days.
16. Logs all unresolved issues and refers to them to the business office management team.
17. Responsible for working daily inpatient uninsured lists timely. Including but not limited to patient assistance screening and getting ABN’s signed
18. Reconciles credit card transactions, daily cash drawer reconciliation. Post and deposits client billing payments from other departments.
19. Reports trending call issues to the QA Coordinator.

KNOWLEDGE/EXPERIENCE:

• Computer skills, will be working in multiple accounting systems.  Hospital, Physician and Home Health
• Mathematical, organization skill and business correspondence skills.
• Basic knowledge in downloading/creating spreadsheets in Microsoft Excel.
• Proficient on 10 key, printers, telephone, copiers, and fax.  Familiar with medical terminology and third party payer methodology.
• Demonstrates a thorough knowledge of Medical necessity and compliance laws.
• Excellent oral/written communication and professional skills in relating to patients and their families.
• Good understanding of other resources or programs available for patients and families.
• Thorough knowledge of SPH payment policies, patient assistance policies, verification and billing processes.

EDUCATION:

• High School diploma or GED required.
• Completes Patient Financial Services I training within first 5 months after hire.

LICENSE/CERTIFICATION/REGISTRY:

Aptitudes:

• Must demonstrate strong interpersonal and persuasive abilities in order to ensure client compliance and cooperation while remaining cognizant of the Hospital’s public image and government regulations.
• Manage and disseminate information with accuracy.
• Open to feedback and a changing environment.
• Ability to achieve cognitive, organization and emotional maturity to deal effectively with multiple tasks, stresses, deadlines, difficult situations and/or customers.
• Possesses interpersonal/communication skills necessary for effective, non-judgmental, and empathetic patient care and customer relations.
• Open to feedback and a changing environment, which requires flexibility in scheduling and department assignments.
• Create, maintain, and promote a respectful work environment consistent with SPH patient and employee standards.
• Ability to make decisions and troubleshoot using various resources available.
• Attention to detail and accuracy
• Ability to accurately, and efficiently document customer interactions
• Must possess a customer-focused mindset.