Customer Service Representative - Medical Billing Call Center

Description:

• POSITION PURPOSE
• Work Remote Position
• Work Hours: 8:30 a.m. to 5:00 p.m. (EDT)
• The Customer Service Representative handles customer inquiries in a timely, professional manner to solicit customer satisfaction through the resolution of issue(s).
• Responds to inquires timely and accurately.
• They are responsible for triaging the call and electronically referring the account to the appropriate area for resolution.
• This individual validates and updates critical demographic and insurance data and forwards the revised information to the appropriate.
• Provides excellent customer service in not only resolving inquires, but assisting the customers navigate through the Ministry Organization and the billing process.
• Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
• Handles all inbound customer inquiries (telephone, fax, mail and web-based patient portal) and responds to customer requests with the highest level of customer quality possible:
• Provides resolution to service requests when possible and refers the inquiry to the functional area if more extensive resolution is required.
• Documents timely and accurately all contacts, issues, actions taken and results within the patient accounting system.
• Transfers and escalates contacts, as appropriate based upon standard operating procedures.
• Communicates with physicians and their office staff, Patient Access, Medical Records/Health Information Management, Utilization Review/Case Management, Managed Care, Ancillary and Nursing staff, as required to clarify customer service inquiries.
• May prepare special reports as directed by the Manager to document billing and follow-up services (e.g., Number of contacts, contact issues/reasons, number of unresolved issues, etc.).
• May serve as relief support, if the work schedule or workload demands assistance to departmental personnel.
• May also be chosen to serve as a resource to train new employees.
• Cross- training in various functions is expected to assist in the smooth delivery of departmental services.
• Other duties as needed and assigned by the manager.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Requirements:

• High school diploma or an equivalent combination of education and experience.
• Associate degree in accounting or business administration highly desired.
• Data entry skills (50-60 keystrokes per minutes).
• Past work experience of at least one year within a healthcare environment, performing customer service, financial counseling, and/or financial clearance is required.
• Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required.
• Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-10, CPT, HCPCS), multilingual and basic computer skills are highly desirable.
• Demonstrated call center experience with the ability to utilize voice/data equipment to fulfill customer expectations is strongly preferred.
• Excellent communication (verbal and writing) and organizational abilities.
• Interpersonal skills are necessary in dealing with internal and external customers, including the ability to interpret customer requirements, recommend and take action to satisfy the customer’s needs.
• Accuracy, attentiveness to detail and time management skills are required.
• Must be comfortable operating in a collaborative, shared leadership environment.
• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

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