Customer Service Associate

Summary

GENERAL SUMMARY:

Represents Patient Financial Services (PFS) by answering the phone and by responding to written and face-to-face inquiries related to billing. Assists patients and their families, attorneys, collection agencies, insurance companies, government agencies and other medical providers with questions concerning patient billing, collection policies, demographic details, financial screening and other related questions. Establishes payment arrangements, including promises to pay, payment contracts, loan programs, and financial assistance on patient accounts per departmental policies. Reviews, processes, comments and scans all written correspondence received by Patient Financial Services into PFS data management system.

PRINCIPAL JOB FUNCTIONS:

1. 1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.
2. 2. *Responds to all general telephone inquiries to Patient Financial Services including checking account balances, payment arrangements, screening for financial assistance, insurance questions and collection policy inquiries; forwards callers to the appropriate departments/personnel as necessary.
3. 3. *Evaluates and reviews financial options, including full payment, loan programs and payment arrangements with patients/guarantors.
4. 4. * Researches, verifies and updates as necessary the accuracy of patient demographic and insurance information, prior correspondence, contacts and payments.
5. 5. *Researches patient concerns and complaints to establish resolution and responses by phone, in person, or by mail correspondence within a timely manner; refers to Patient Experience Specialists as appropriate.
6. 6. Opens, sorts and scans daily mail received by PFS; may follow-up with correspondence or phone call as needed.
7. 7. Processes returned mail and may attempt to locate guarantors with return mail or bad addresses.
8. 8. Scans documents into document imaging system, as needed.
9. 9. Performs cashiering functions by receipting money received for patient payments on hospital, non-patient services and general fund deposits, as needed.
10. 10. Researches and evaluates patient credit balances and send refund payments, as needed.
11. 11. Follows Medical Center protocols in communicating and releasing patient protected health and financial information.
12. 12. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk “*”).

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. 1. Knowledge of patient accounting operations and quality improvement techniques.
2. 2. Knowledge of credit and collection laws and practices, third party payer regulations, and Joint Commission regulations.
3. 3. Knowledge of federal regulations including COBRA, HIPAA, Medicare, Medicaid and Bryan Medical Center's Corporate Compliance Plan.
4. 4. Knowledge of computer hardware equipment and software applications relevant to work functions.
5. 5. Ability to maintain confidentiality relative to sensitive information and documents.
6. 6. Ability to communicate effectively both orally and in writing.
7. 7. Ability to plan, prioritize and coordinate multiple tasks.
8. 8. Ability to establish and maintain effective working relationships with all levels of personnel, medical staff, volunteer and ancillary departments.
9. 9. Ability to keep current on all policies, procedures and regulations affecting Patient Accounts operations through departmental training and staff meetings.
10. 10. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

1. 1. High school diploma or equivalency required. Associates degree in business or accounting-related field preferred. Prior experience in healthcare or customer service preferred. Must be 19 years of age to witness legal consents.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) – Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.#LI-RH1