Customer Care Specialist - MedStar Unified Revenue Cycle Organization

General Summary of Position MedStar Health is looking for a Customer Care Specialist to join our team in the MedStar Health Customer Service Call Center. Schedule is 9:30 AM - 6:00 PM, Monday through Friday. We are currently seeking a candidate with exceptional customer service skills and experience in medical billing. As a Customer Care Specialist, you will serve as the primary post-service contact for the MedStar Health Customer Service Call Center. You will identify the nature of inquiries, discern potential implications for internal & external entities, and use both MedStar billing systems (IDX and SMS), internal/external resources, applications, and processes to resolve cases. You will provide a single point of contact from origin through final resolution for all patient billing, coding, service, and insurance concerns. You will use appropriate guidelines and discretionary authority to make decisions concerning proper resolution of documented service recovery cases. Special emphasis will be on educating the patient, building rapport, and service recovery, all aimed at enhancing the patient experience. Primary Duties Advocate on the patient’s behalf to achieve best results, gain patients’ trust and build rapport. Interact regularly with patients, MedStar Health staff from all areas, collection agency liaisons, website vendors, outside labs, etc. Use established guidelines to make independent decisions concerning specific patient issues in need of resolution. Answer and resolve patient/guarantor inquiries daily via telephone, mail, fax, and email. Meet departmental weekly standards for calls taken, mail handled, and other forms of customer contacts resolved. Meet specific standard turnaround times as they apply to number of calls answered, speed of answer, hold time, personal call abandonment rate, etc. Meet expected turnaround times for resolving interdepartmental issues, cases deemed “urgent” or in need of special handling, and response time to customers. Serve as the single point of contact for the patient. Liaise, advocate, research, and analyze documents, records, prior precedent‐setting cases, discuss and review with both internal and external sources, etc., until final adjudication or resolution is achieved. Use MedStar Health's billing systems and the MedStar Payment Portal to help customers with their billing and payment concerns. Annotate the invoice or account after each inquiry to ensure proper documentation of inquiries and resolutions. Ensure correct upload of documents for proper retention. Knowledge of the functions of all MedStar Health's non‑telephony methods of customer contact. Apply knowledge of MedStar Health's Managed Care contracts and the associated rules for claim processing to achieve proper reimbursement and customer satisfaction. Participate in training sessions, workshops offered, staff meetings, work events, task force, committees, and community outreach efforts. Communicate to leadership any system or procedural problems/inconsistencies to prevent recurrence and/or improve existing processes. Correct invoices and accounts in both systems that have erroneous registration and/or insurance information and ensure all associated claims have the correct financial classification for timely processing/reprocessing. Exemplify Spirit Values in all activities in areas of service, resource utilization, high quality outcomes and effective communication. Interview patients in need of referral or recommendation to appropriate support and/or charity care programs. Propose budget/payment plans to customers as the situation warrants and in accordance with MURCO policies and Maryland State regulations. Keep abreast of regulatory and specific changes as they relate to HCFA 1500 and UB04 billing requirements and payer‑specific follow‑up. Maintain departmental QA standards within established error rate. Meet the established standards for abandoned calls, duration of calls, and amount of time a patient is held in queue. Qualifications High School Diploma or GED. 2 years of experience in patient accounting or related healthcare field. 1 year of customer service experience. Associate or bachelor’s degree preferred. Minimum Qualifications This position has a hiring range of $20.17 - $35.04. #J-18808-Ljbffr MedStar Health