Customer Service & Collections Representative

Regal Medical Group•Los Angeles, CA

2d•Onsite

About The Position

This position will provide day-to-day support as a Customer Service and Collections Representative (CSCR) in the Centralized Billing Office (CBO). The primary role of this position involves: answering incoming phone calls from patients regarding their accounts; making outgoing collection calls to patients regarding outstanding balances; and posting payments received by the CBO onto patient accounts. The CSCR is responsible for accomplishing assignments in accord with established policy, procedure and production standards. This position must be equally capable of working independently as well as part of a team effort. Hours for this position are 8:00 am to 5:00 pm, Monday thru Friday.

Requirements

2+ years of billing or collections experience required.
Knowledge of insurance agency operating procedures and practices.
Knowledge of governmental legal and regulatory provisions related to collection activities.
Must have an excellent understanding of collections and medical insurance payment posting.

Nice To Haves

Previous working knowledge if NextGen platform preferred.
Previous working knowledge of ERA/EFT payment posting preferred.

Responsibilities

Request and post credit card payments for patient accounts during phone contact with patients/callers who have outstanding balances via both incoming and outgoing calls.
Discuss and establish payment plans for patients that require extended terms to pay off a balance.
Follow department policy when transferring credits, charge disputes and lost payments.
Maintain the accounts receivable database in the office computer system and review the data input for completeness and accuracy.
Update account information and transfer charges to the correct agency or carrier.
Analyze customer problems or issues by collecting information and documenting the call.
Research issues using NextGen and/or any resource necessary.
Take necessary action to resolve issues, or inform the patient of expected resolution time and return call.
Follow through on all patient calls promptly and accurately.
Update and document NextGen notes with all information pertaining to the call.
Gather information from the caller/patient to update system information including correct address, telephone numbers, guarantor information, employer and insurance information.
Accurately and thoroughly read and apply payments and denials from payer remittance advices and explanations of benefits (ERAs/EOBs) received in electronic format or hard-copy paper documents.
Balance batches, readily identify discrepancies, and communicate with payers to acquire additional information if needed to post ERAs/EOBs.
Follow appropriate policies for payment appeal, balance write-offs, or transfer to a/r department as appropriate.
Prioritize work received and complete in a timely manner.
Update patient accounts using appropriate documents and information.
Identify and correct billing errors on patient accounts.
Review delinquent accounts with Director and follow credit/collection policies including writing adjustments to accounts.
Explain clinic billing and payment procedures to patients, respond to patient requests & complaints regarding their account and assist with claims filing if needed.
Acquire patient billing information from physicians and determine the amount, if any, that should be collected from patient.
Communicate with clinic personnel related to patient accounts and serve as primary problem-solver.
Answer correspondence and make calls regarding payment of account balance in full, patients who have kept insurance payments and patients who violate payment agreements, within departmental policy and procedure.
Respond to and follow through on patient inquiries to assure patient satisfaction.
Prepare information for collection agency when appropriate.
Post all actions related to patient’s account into computer system as permanent records.
Identify delinquent accounts, aging period and payment sources; follow and report status of those delinquent accounts.
Review each account via computer, reports and other information sources.
Evaluate patient financial status and establish budget payment plans.
Assist other office personnel in the performance of their duties as assigned and as workload permits.
Function as a relief for other personnel in the department, as appropriate and to facilitate coworkers’ taking time off.
Participate in any required accuracy audit and review process.
Work in conjunction with other CBO employees as assigned by the Director.
Maintain strictest confidentiality and conform to all HIPAA requirements and company HIPAA policies.
Perform all other duties as directed by management.