Customer Service Specialist

Advocate Aurora Health candidates must live in these states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL*, IN, KS, KY, LA, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

ESSENTIAL FUNCTIONS:

1. Assesses the nature of incoming calls, identifies, and completes appropriate action in a prompt manner.

2. Activities may include, researching specific transactions on a claim, re-sending patient statement, re-billing a claim, adding or changing insurance information, verifying eligibility on account, pulling an explanation of insurance benefits for payment information, requesting an adjustment on a claim, sending itemized statements, sending a Financial Aid Application to a patient or referring to Financial Counseling, as appropriate, and directing customer to the appropriate responsible party to resolve concerns outside PFS, as needed, and posting comment(s) into Epic documenting patients concern and the actions taken.

3. Provides direction to the other members of the team, serves as a resource for questions.

4. Researches the more difficult accounts and questions.

5. Prioritizes the workload based on guidance from management. Organizes work/resources to accomplish objectives and meet deadlines.

6. Understands all key processes in PFS including activities related to billing, collections/follow-up, posting and customer service and how their actions impact the Revenue Cycle.

7. Assists in the development of training materials.

8. Maintains compliance with federal, state and local regulations, HIPAA and the Corporate Responsibility Program.

9. Maintains the privacy and security of all confidential and protected health information. Uses and discloses only that information which is necessary to perform the function of the job.

10. Reports issues and trends to appropriate management personnel in PFS and works collaboratively to develop solutions.

11. Participates in all educational activities and demonstrates personal responsibility for job performance.

12. Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations.

13. Maintains satisfactory attendance and punctuality record as set forth by Wake Forest Baptist Medical Center policies. 14. Performs other relevant work functions, as requested.

SKILLS/QUALIFICATIONS:

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  Demonstrates the ability to work independently Consistently demonstrates a positive and professional attitude at work
  
  



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  Maintains stable performance under pressure
  
  



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  Handles stress in ways to maintain relationships with patients, customers and co-workers
  
  



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  Ability to communicate effectively both orally and in writing
  
  



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  Strong computer and math skills, knowledge of Excel is required
  
  



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  Demonstrates leadership in establishing and achieving goals
  
  



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  Extensive knowledge of Medicare, Medicaid and all other third party insurance guidelines
  
  



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  Ability to exercise independent judgment in unusual or stressful situations
  
  



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  Demonstrates in-depth knowledge and experience in the following technology solutions: patient accounting, optical imaging and scanning, patient systems and internet-based insurance websites
  
  

WORK ENVIRONMENT: Clean, comfortable, office environment Work may be stressful at times Contact may involve dealing with angry or upset people Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergencies Ability to manage effectively the exposure to potentially infectious material per OSHA guidelines PHYSICAL

REQUIREMENTS: 0% 35% 65% to to to 35% 65% 100% N/A Activity X Standing X Walking X Sitting X Bending X Reaching with arms X Finger and hand dexterity X Talking X Hearing X Seeing Lifting, carrying, pushing and or pulling: X 20 lbs. maximum X 50 lbs. maximum X 100 lbs. maximum

EDUCATION/EXPERIENCE: High school diploma or GED equivalent and two years of customer service experience. Two years business office experience in a physician practice or hospital preferred.

LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A

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