Customer Service Specialist

Customer Service Specialist

The remote Customer Service Specialist will be responsible for receiving and triaging all incoming patient and insurance calls, initiating outbound calls, and addressing questions and concerns regarding patient accounts through other platforms, as needed. You will be required to work in real time with a patient on the line. Prior experience in working with difficult or upset customers and knowing how to manage escalation is necessary. The primary responsibility for CSR's is answering phones and returning voicemails to callers. The secondary responsibility is to resolve written requests from an assigned worklist. Research into multiple files and systems, as well as collaboration with several departments is necessary. This takes critical thinking and a thorough working knowledge of Revenue Cycle Management (RCM) to be able to handle the request effectively and efficiently. This position has daily production benchmarks to help measure progress in meeting KPI's. This position requires strong interpersonal skills to regularly interact professionally, promptly, and courteously with patients, internal teams, and surgery centers, while responding to their inquiries/requests. Collections experience is very helpful to work accounts and assist in working requests and resolving patient concerns. Knowledge of how to interpret an Explanation of Benefits (EOB, RA, Remit) and how to read the PAS Ledger and notes is a must. This position requires a high level of multi-tasking, technical ability, prioritization, time management, and organization. Accessing multiple systems and applications is a requirement. Prior A/R experience in a medical setting preferred. May be assigned additional delegated responsibilities and special assignments by Central Billing Office Management. Individuals should be flexible to perform a variety of duties. Bilingual is preferred.

Responsibilities:

• Handle a high volume of in-and-outbound phone calls to address various questions and concerns.
• Researches any overdue account balances that are fully or partially unpaid and follow up by mail and/or phone to patients on delinquent payments.
• Respond promptly to patient/internal team inquiries with clear communication and high-quality service.
• Research customer's accounts thoroughly and documents appropriately.
• Resolves discrepancies and prepare adjustments and refunds as necessary.
• Collaborates with various departments within the Central Billing Office to resolve requests.
• Ensure that all information regarding collection activity on accounts is entered accurately into the system.
• Responds to written requests submitted electronically and ensures timely resolution.
• Brings recurring issues to the attention of the department supervisors/manager.
• Conduct duties with empathy, support, respect, and professionalism at the core of every interaction.
• Evaluates and identifies priority accounts.
• Performs other duties as required.

Required Skills:

• Basic level mathematical proficiency, with a strong ability to understand, interpret and develop spreadsheet data.
• Patient collections experience for 1 year or more preferred.
• Excellent internal/external customer services skills both verbal and written.
• Must exhibit the ability to articulate well in email and written form and send clear and concise communication, with internal requests following UPSI internal communications protocols.
• The ability to meet critical deadlines.
• Intermediate knowledge of Word, Excel, PowerPoint, Access, and Outlook.
• Sound judgement and strong skills with respect to interpersonal relations, critical thinking, problem solving and analysis.
• Be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
• Must be proficient in computer skills necessary to perform job duties and must have strong knowledge of computerized billing systems.
• Must possess a positive attitude to enhance a cooperative and energetic work environment. Excellent knowledge of health care billing procedures, documentation, regulations, payment cycles and standards.
• Must be flexible to perform the various tasks required by the department on a daily basis.
• High School Diploma or equivalent