RCM - Patient Customer Service Specialist

Lifeline ConnectionsVancouver, WA
Remote

About The Position

Lifeline Connections is a community-based behavioral health organization that specializes in providing confidential and compassionate care to individuals who experience substance use and/or mental health conditions. Our Vision - As the premier provider of substance use and mental health services in the Pacific Northwest, we are respected and the most trusted resource for behavioral health treatment and whole-person care. We provide a comprehensive continuum of coordinated quality services, foster enduring relationships, and empower our communities to truly thrive. Our Mission - Through superior customer service, high quality programs, and well-trained and dedicated staff, we inspire hope and support lifesaving changes for people affected by substance use and mental health conditions. POSITON TITLE: RCM- Patient Customer Service Specialist Non-Exempt Position RESPONSIBLE TO: Revenue Cycle Manager Work Location: Remote in SW Washington, NW Oregon

Requirements

  • Minimum of one (1) year of experience in medical billing, collections, healthcare revenue cycle operations, or a nonprofit healthcare environment preferred.
  • Minimum of one (1) year of customer service experience required, preferably in a healthcare or patient-facing environment.
  • Working knowledge of medical billing practices, insurance claim processing, Medicaid programs, ICD-10 and CPT coding, HCFA 1500 and UB-04 claim forms, and payer requirements for reimbursement.
  • Understanding of healthcare insurance eligibility, benefits verification, patient financial responsibility, and collections processes.
  • Experience with electronic health record (EHR) systems required; prior experience with Qualifacts CareLogic preferred.
  • Proficiency in Microsoft Office applications, particularly Microsoft Excel, with the ability to create, maintain, and analyze reports accurately.
  • Demonstrated ability to maintain superb attendance and reliability.
  • Strong interpersonal skills with the ability to work collaboratively and effectively as part of a team.
  • Highly organized and detail-oriented, with strong analytical, problem-solving, and critical-thinking abilities.
  • Excellent verbal and written communication skills, including the ability to communicate professionally with patients, insurance representatives, coworkers, and leadership.
  • Ability to manage multiple priorities, meet deadlines, and perform effectively in a fast-paced environment while maintaining accuracy and quality standards.

Nice To Haves

  • An associate’s degree, certification, or formal training in Medical Billing, Health Information Management, or a related field may be substituted for experience.

Responsibilities

  • Verifies patient insurance eligibility and benefits through payer websites, electronic verification tools, and direct contact with health plans; follows up as necessary to confirm coverage and resolve eligibility issues.
  • Responds to patient inquiries regarding medical billing, insurance coverage, account balances, payment options, and related financial matters.
  • Contacts patients regarding outstanding balances, denied claims, payment requests, and overdue accounts; establishes and monitors payment arrangements as appropriate.
  • Processes and submits patient refund requests in accordance with established policies and procedures.
  • Serves as the primary backup for the RCM Medical Payment Posting Specialist.
  • Maintains daily account follow-up worklists and assigned account inventories while meeting established productivity and quality standards.
  • Identifies, researches, and resolves credit balances, missing payments, unapplied cash, and other account discrepancies.
  • Audits patient accounts to ensure accuracy and completeness of billing and payment information.
  • Conducts collection activities for unpaid patient balances in accordance with organizational policies and applicable regulations.
  • Provides outstanding customer service to patients, staff, providers, and external stakeholders.
  • Answers incoming telephone calls, emails, and other communications, directing inquiries appropriately and ensuring timely resolution.
  • Determines patient eligibility for Sliding Fee Scale discounts and other available funding sources.
  • Assists patients with funding applications and provides Good Faith Estimates as required by applicable regulations.
  • Documents all activities, communications, and findings in accordance with established policies and procedures, ensuring the integrity and completeness of account records.
  • Maintains current knowledge of organizational policies, payer requirements, industry standards, and applicable federal and state regulations.
  • Establishes and maintains professional, effective working relationships with patients, coworkers, providers, and external contacts.
  • Maintains strict confidentiality and complies with all applicable HIPAA requirements and 42 CFR Part 2 regulations.
  • Demonstrates strong problem-solving skills and exercises sound judgment in resolving patient account and billing issues.
  • Maintains knowledge of patient statement systems and ensures patient statements are generated and distributed accurately and timely.
  • Communicates professionally and effectively, both verbally and in writing, with patients, insurance companies, coworkers, and leadership.
  • Effectively prioritizes workload to meet multiple deadlines, productivity standards, and organizational objectives.
  • Functions as an integral member of the Revenue Cycle Management team and collaborates effectively with other departments.
  • Supports and adheres to agency policies, procedures, and organizational values.
  • Participates in special projects and performs other duties as assigned by the supervisor.

Benefits

  • multiple options for medical, dental, and vision coverage for employees and their eligible dependents
  • employer-paid Short Term Disability, Long Term Disability, and Life Insurance
  • access to supplemental coverage options
  • 401(k) retirement plan
  • generous paid time off
  • paid holidays and personal holidays
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