Cust Svc Rep Single Bill Offic / PA Customer Service

Hartford Healthcare•Farmington, CT

7d•Onsite

About The Position

In a multi-entity hospital and professional office environment, the Customer Service Representative is responsible for analysis, investigation and resolution of patient and insurance balances as a result of a call or inquiry to the department. The SBO Customer Service Department works with patients, insurance companies, attorney offices, etc with regard to their Hartford HealthCare medical bills. The department operates a call center to field calls/disputes/questions from providers, patients and customers.

Requirements

High School Diploma or equivalent experience.
At least three (3) years of revenue cycle experience including insurance and self-pay billing, remit processing, patient access and/or collections experience.
Minimum of 1 year of experience in a multi-entity system with EPIC.
Outstanding customer service and interpersonal skills.
Superior communication, organizational, and analytical skills.
Understanding of Hospital and Professional revenue cycle.
Ability to work in a high volume setting and respond to patient inquiries in a timely manner.
Ability to identify and communicate payer and/or system trends.
Knowledge of payer contracts, regulations and guidelines, as well as State and Federal laws relating to billing, collection, and financial assistance procedures.
Familiar with medical and insurance terminology.
Proficient in the use of a computer and relevant hospital software applications.
Understanding and adherence to HIPPA Regulations and Release of Information Rules.
Models teamwork through cooperation and collaboration within and outside the work group.
Ability to attain productivity and quality standards per department requirements.

Nice To Haves

Bachelor's degree is preferred.
Previous experience in patient relations or customer service for a healthcare entity is preferred.
English, Spanish and Polish would be preferred.

Responsibilities

Responds and takes action related to calls, emails, and faxes related to patient billing in a timely and professional manner.
Uses a patient-centric approach to answer questions and provide information.
Collects patient payments as appropriate.
Understands all payer regulations to effectively communicate with patients about charges, payments and adjustments on their account.
Investigates patient inquiries/disputes surrounding charging, coding, payments, locations, services, insurance coverage, etc.
Works with individuals when appropriate at various levels of the organization to find resolution on patient disputes.
Updates account information (addresses, insurances, etc.) and rebills as appropriate to initiate the next steps in the billing and collection cycle.
Provides discharge, billing, and other related information to appropriate internal departments or external companies.
Attains productivity and quality standards set by the department leadership team.
Directs inquiries to appropriate departments if not related to insurance and patient balances.
Responds to customer requests for Pricing Estimates.
Follows all Call Flow steps and strives to meet Average Handle Time, Abandoned Calls, Returned to Queue/Short call and other call center metrics.
Agrees to continuously improve to achieve the highest audit scores possible.
Offers MyChart and other new services to patients when applicable.
Works directly with self-pay early-out vendors and collection agencies to address and respond to patient disputes related to billing.
Identifies barriers to efficient departmental operations related to self-pay billing and takes an active role in developing appropriate solutions using the H3W model.
Representative is willing to learn and actively work in the dispute work queue when necessary, including split shifts between the call team and dispute team.
Assists the self-pay follow up team in areas such processing financial assistance applications, preparing patient refund requests, processing bankruptcy notifications, return mail, etc.