Customer Service Representative II (Billing Support Resolution Team) - Boynton Beach, Florida

Customer Service Representative II (Billing Support Resolution Team)

We have an exciting opportunity to join our team as a Customer Service Representative II.

Billing Support Resolution (BSR) Team

Manages complex and escalated patient billing concerns referred by Patient Experience, physician practices, Revenue Cycle teams, senior leadership, and external agencies such as the OAG and BBB.

Researches and resolves complicated patient account issues involving hospital and professional billing, insurance processing, laboratory charges, collection activity, financial responsibility, and other sensitive billing matters.

Coordinates across departments to drive resolution, partnering with clinical practices, billing teams, Patient Experience, International Patient Services, collection agencies, and operational leadership to ensure accurate and timely follow-up.

Supports a strong patient financial experience through clear communication, service recovery, case documentation, trend reporting, and identification of process improvements that can prevent future billing issues.

The Customer Service Representative II (CSR II) will act as a primary contact for NYU Langone patients who have questions about their balances, benefits, and insurance. Answer phone calls and/or electronic messages and follow-up on issues which could include submitting bills, calling insurance, correcting information, making outbound calls to patients, and entering detailed information in the billing system as assigned by management. Follow established protocols/scripts and handle issues in prescribed timelines but use independent judgement to resolve patient inquiries to maintain high-levels of patient satisfaction. The CSR II will establish and maintain effective relationships with patients and their families via active listening, empathy, rapport, courtesy and professionalism. The candidate will also work closely with customer service representatives to assist with daily operations.

Job Responsibilities

• Perform billing tasks assigned by management which includes answering calls, logging call data into Customer Relationship Management (CRM) software, entering data, making outbound calls to patients and following-up on open issues, processes credit card payments, and/or other related responsibilities.
• Provide input on system edits, processes, policies, and billing procedures to ensure that we maintain high-levels of patient satisfaction and reduced call volume.
• Perform daily tasks in assigned work queues and according to manager assignments.
• Identify payer and provider credentialing issues and address them with management.
• Follow workflows provided in training classes and request additional training, management assistance, and medical coding expertise as needed.
• Responsible for assisting the Customer Service Representative(s) handle complex issues, and be able to escalate / deescalate as necessary
• Utilize CBO Pathways and resources guide to determine the actions needed to resolve patient balances and/or questions.
• Enter account notes using standard formatting in Epic CRM and/or other systems.
• Review unpaid balances and unresolved patient inquiries and make outbound calls to patients following established protocols.
• Ensure that items in assigned work queue(s) are resolved within required timeframes using payer website, billing systems, and CBO pathways.
• Adhere to general practices, operational policies and procedures, FGP guidelines on compliance issues and patient confidentiality, and regulatory requirements.
• Communicate with providers, patients, coders, collection agencies, or other responsible persons to ensure that claims are correctly processed by third party payers
• Work with management to develop processes and workflows to improve how we can better service patients.
• Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials or Authorizations.
• Responsible to review accounts to identify billing discrepancies.
• Maintains a positive relationship with other teams within the central billing office and customer service representatives.
• Participate in workgroups and meetings. Attend all required training classes.
• Read and apply policies and procedures to make appropriate decisions.
• Coordinate functions and work cooperatively with others.
• Work with management to develop processes and workflows to improve patient service
• Maintain a positive relationship with other teams within the central billing office and customer service representatives.
• Perform other related duties as assigned.

Knowledge, Skills and Abilities

• Strong critical thinking and effective listening skills
• Excellent interpersonal, oral and written communication skills
• Epic systems experience preferred
• Microsoft Office experience preferred
• Strong PC skills preferred
• Foreign language preferred
• Recent experience in a major inbound call center preferred
• Some knowledge of CPT and ICD10 preferred
• Some knowledge of Healthcare revenue cycle / professional billing preferred
• Professional demeanor and positive attitude required
• Willingness to work a flexible schedule required
• Team Oriented required
• Adaptable to change
• Self-control and patience
• Strong Time management skills
• Ability to operate under stressful conditions

Patient Experience & Access

• Drives consistency in every patient and colleague encounter by embodying the core principles of our FGP Service Strategy CARES (Connect, Align, Respond, Ensure, and Sign-Off)
• Greets patients warmly and professionally, stating name and role, and clearly communicates each step of the care/interaction as appropriate
• Works collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions and inquiries whether in person, by phone or via electronic messaging.
• Proactively anticipates patient needs, and participates in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.
• Shares ideas or any observed areas of opportunity, to improve patient experience and patient access, with appropriate leadership. (i.e. ways to optimize provider schedules, how to minimize delays, increase employee engagement, etc.)
• Partners with Patient Access Center and Central Billing team members to support collaboration and promote a positive patient experience.
• Takes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.

Minimum Qualifications

To qualify you must have a High School Diploma or GED. Experience in customer service, medical billing, accounts receivable, insurance, or related duties; Knowledge of CPT and ICD10 utilized in medical billing; English usage, grammar and spelling; basic math; 2 years experience in a similar role. Light, accurate keyboarding skills required. Good Customer Service skills are required. Candidates are required to pass a Customer Service scenario assessment prior to onboarding.