Customer Experience Representative

LCMC Health

80d

About The Position

The Customer Experience Representative serves as the hospital's primary contact for all patient billing inquiries. Acts as a liaison between LCMC Health 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 to ensure swift resolution of outstanding balances. Fulfills the organization's mission of care and service by providing superior customer service to the patient community. Customer Experience Representative will also analyze posted transactions to determine why there is a credit balance and is responsible for accurate completion and resolution of potential credit balances for health plan payers and patients/guarantors. This position requires detailed analysis and critical thinking to determine what is necessary to correct an account. After review, if 1) a refund is appropriate to either the patient or insurance company, 2) a payment transfer is necessary, or 3) a reversal or correction of a contractual allowance or an administrative adjustment is warranted, then the representative is responsible to correct the postings and/or refund the overpayment to the correct payer(s).

Requirements

• High School Diploma/GED or equivalent OR 2 years of experience in accounting, handling cash and/or cash reconciliation in a healthcare facility/hospital.

Responsibilities

• Accepts inbound phone calls from patients, early out and bad debt vendors, physician offices, insurance carriers, etc. within a specific response-to-call timeframe and with the intent to resolve the caller’s concern immediately.
• Follows scripts as provided by the call center manager to facilitate consistent and expedient account resolution.
• Provides exceptional customer service that aims to improve patient and/or guarantor relations and contribute to a positive work environment.
• Clearly explains charges to customers, reports any charge/payment errors to managerial staff, and resolves any errors within LCMC’s computer system.
• Utilizes multiple resources to resolve patient inquiries while on the phone or preparing/reviewing billing correspondence.
• Handles all communication (telephone, email, fax, interpersonal) with patients and other departments within the CBO.
• Negotiates full payment from patients and helps them set up an agreeable payment plan.
• Collects patient payments and follows levels of authority for posting adjustments.
• Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB).
• Generates refund requests and routes resolution to manager for patients and third-party payers; refunds overpayments and/or transfers payments to the appropriate account/accounts.
• Responsible for responding to insurance/patient requests for refunds in a timely manner (within 24 hours of receipt of message for phone calls).
• Identifies the originating cause of the need for a refund and compiles a report of recurring issues to management.
• Responsible for correcting errors in the calculation and posting of insurance contractual adjustments.
• Completes documentation of daily activities for individual productivity tracking and for patient account volume management.
• Cross-trains in other related business office functions to ensure smooth operation of the department.
• Documents any request or concern received via mail, e-mail, telephone, written correspondence, or in person on the patient's account concisely, including future steps needed for resolution, in a prompt and courteous manner.
• Performs scanning, filing, data entry, and other duties as assigned.
• Acts in accordance with LCMC Health’s mission and values, while serving as a role model for ethical behavior.
• Adhere 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.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 501-1,000 employees