Customer Service Representative III - Boynton Beach, Florida

Customer Service Representative III - Boynton Beach, Florida

We have an exciting opportunity to join our team as a Customer Service Representative III. Under general guidance, the Customer Service Representative III (CSR III) provides support within the Customer Service, Financial Clearance/Authorization, and Accounts Receivable CBO departments. The CSR III will act as a primary contact for NYU Langone patients who have questions about their balances, benefits, and insurance. In addition, CSR III will assist the Financial Clearance/Authorization and Accounts Receivable departments to handle the daily tasks/work assignments as determined by management.

Job Responsibilities:

• Perform patient resolution activities 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. Routes calls to other teams as needed.
• Perform billing tasks assigned by management which may include data entry, claim review, charge review, pre-authorization approvals, accounts receivable follow-up, or other related responsibilities.
• Provide input on system edits, processes, and policies, training materials and billing procedures to ensure that we maintain high-levels of patient satisfaction, reduced call volume, and maximization of revenues.
• Identify payer, provider credentialing, and/or coding issues and address them with management.
• Identify, review and communicate trends related to lagged payments, aging AR, customer experience defects and other items that delay processing of claims.
• Follow workflows provided in training classes and request additional training, management assistance, and medical coding expertise as needed.
• Assist the Customer Service Representative I (CSR I) and Service Representative II (CSR II) to handle complex calls and accounts and be able to escalate or deescalate as necessary.
• Monitor, review and address assigned WQs and reports necessary to maintain acceptable levels of accounts in work queues. Report accounts outside of teams turnaround time (TAT).
• Monitor items in assigned work queue(s), ensuring they 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.
• Utilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned work queue(s) using payer websites, billing system information and training within expected timeframe.
• Serve as a subject matter expert for all policy, procedure and process items related to professional billing revenue cycle
• Cross cover and train within all areas as assigned by management including Customer Service, Financial Clearance/Authorization, and Accounts Receivable.
• Maintain a positive relationship with other teams within the central billing office and all team members.
• Participate in workgroups and meetings. Attend all required training classes. Escalate issues to management as needed. Maintain confidentiality. Read and apply policies and procedures to make appropriate decisions. Coordinate functions and work cooperatively with others. Explain processes and procedures to others; performs other related duties as assigned.
• 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.)
• Work with management to develop processes and workflow to improve patient service
• Maintain a positive relationship with other teams within the central billing office and customer service representatives
• Assist the Customer Service Representative I (CSR I) and Customer Service Representative II (CSR II) to handle complex calls and accounts and be able to escalate or deescalate as necessary.

Knowledge, Skills and Abilities:

• Strong critical thinking and effective listening skills
• Epic systems experience preferred
• Microsoft Office experience preferred
• Strong PC skills required
• Adaptable to change
• Self-control and patience
• Effective communication skills
• Strong time management skills
• Some knowledge of CPT and ICD10 preferred
• Healthcare revenue cycle / professional billing preferred
• Professional demeanor and positive attitude
• Willingness to work a flexible schedule.
• Team Oriented
• Ability to operate under stressful conditions
• Ability to learn and analyze
• Demonstration of some management skills
• Performs other duties as assigned

Minimum Qualifications:

To qualify you must have a High School Diploma, College credits preferred. 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; 3 years experience in a similar role. Candidates must receive a score of 35 words per minute (wpm) or greater on the typing assessment that will be administered prior to onboarding. Good Customer Service skills are required. Candidates are required to pass a Customer Service scenario assessment prior to onboarding.

Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Florida is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration.