Non-Clinical - Administrative - Customer Service Representative

Customer Service Representative

The Customer Service Representative performs various routine and complex clerical tasks; and deals with patients, family members, visitors and clinic personnel in other departments to ensure good internal and public relations.

Specific skills needed include knowledge of medical billing/collections practices and basic medical coding; computer data entry skills; ability to deal courteously with patients; bilingual in Spanish desired.

Education/experience/training required includes minimum 1 year of experience in billing and collections. High school diploma or equivalent or 7 years of experience in billing and collections. Preferred: 2 years of experience in billing and collections. Certification, experience, or proficiency in EPIC Applications.

Duties and responsibilities include safeguarding and preserving the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies. Ensuring a safe patient environment and adherence to safety practices per policy. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care. Receive and resolve patient complaints regarding insurance billing, and initiate accurate account adjustments; follow all billing problems through to conclusion. Answer all correspondence relating to billing questions; make appropriate financial arrangements. Verify insurance status, eligibility and general account information. Assist patients with courtesy billing and update insurance information as necessary. Forward billing to appropriate carriers to ensure timely and accurate payment; demonstrate complete knowledge of all appropriate carriers. Perform reconciliation of refund accounts; attach documentation and forward to bookkeeper to process refund checks; identify problems and follow through to conclusion. Review credit statements for correct recipient of refund. Perform other tasks as assigned.

Personal qualities include recognizing differing values and being culturally sensitive. Flexible, adaptable. Personable, courteous, punctual, honest. Creative, organized, able to establish priorities. Professional appearance and attitude. Ability to make good decisions. Commitment to the organization for which you work. Ability to keep confidential information. Effective time management skills and sound work ethics. Ability to work at a computer and input data several hours each day.

Communication skills include talking or hearing essential to communicate with patients and staff. Good communication skills; read, speaks and writes English fluently. Bilingual skills preferred. Strong interpersonal skills. Actively participates in staff meetings.

Bestica Healthcare