Customer Service Representative

Career Opportunity at Lehigh Valley Health Network Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Summary Works collaboratively with department and vendor management team to enhance the customer experience through the delivery of exceptional Customer Service. Conduct monthly quality assurance review for colleagues, identifying opportunities for education and process improvement through education or workflow changes. Remains current on all billing regulations, payer clinical and payment guidelines and procedural changes that impact claim payment identifying workflow changes, claim edits and colleague education. Job Duties Leads team responsible for accurate and timely resolution of escalated patient inquiries utilizing a working knowledge of charging, coding and insurance requirements related to hospital and physician claims. Conducts quality reviews of patient calls to ensure inquiries are being addressed applying emotional intelligence with an empathetic approach toward crucial conversations with patients in a compassionate, efficient manner consistent with department standards. Manages the new colleague on boarding process ensuring all colleagues receive a detailed orientation including comprehensive training on multiple legacy systems as well as navigating the hospital information system. Collaborate on the development of training material and conducts training sessions targeting workflow process, customer experience techniques, insurance requirements, regulatory and coding education. Education is modified as necessary to address the needs of individual colleagues. Conducts desk side support with colleagues to review productivity, quality and address any questions/concerns regarding workflow, departmental protocols or new procedures established to address LVHN, industry, or regulatory changes. Serve as the subject matter expert and escalation point for colleagues, maintaining a comprehensive knowledge of entire revenue cycle with a concentration in registration related functions to ensure maximum financial recoveries through accurate billing and collections. Supports Supervisor/Manager in monitoring real time patient calls to ensure Industry Standard Call Center best practices are achieved as demonstrated through KPI's including, but not limited to, talk time, call quality and abandonment rate. Monitor and address work queues assigned to the Customer Service and associated vendors to ensure timely resolution of accounts. Actively participates in Epic upgrades, new service/facility implementation and transition of data from legacy systems to Elkay archive. Plays an active role in implementation, workflow modifications and training as it relates to customer service areas of responsibility. Minimum Qualifications High School Diploma/GED 5 years experience in Hospital or Physician billing, follow up or collections and 3 years customer service call center experience in a healthcare setting and 3 years experience working with Epic Resolute System in a Hospital or Professional Business Office Environment. Required to attend and pass DOE and LVHN Revenue Cycle Training within 6 months from the date of hire. Working knowledge of insurance carrier billing and payment policies, standard ANSI denial and remark codes, ability to review and decipher insurance carrier EOB's. Computer literacy especially with Microsoft Office Suite, demonstrating proficiency in MS Excel, Word and Outlook. Ability to meet deadlines and work with frequent interruptions. Demonstrates strong leadership, the ability to effectively manage and embrace change, effective decision-making and delegation of tasks. Preferred Qualifications Associate's Degree Knowledge of Medical Terminology. Working knowledge of HCPCS, CPT and NDC codes. Working knowledge of ICD-10 coding. Physical Demands Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR. Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.