The representative is responsible for handling and resolving incoming phone calls from patients, insurance carriers and or physician offices. Responsibilities will include collections of outstanding patient balances, establishing payment arrangements, updating patient and guarantor account with new demographic and insurance coverage information.
Expeditiously handle large volume of calls and perform work in a timely manner.
Attempt to collect full payment from patient or guarantor in a courteous manner.
Establishes payment arrangements per guidelines. Document terms in billing system.
Application of payments collected over the phone to each date of service. Clearly document in system summary of work and follow up steps after each call.
Handle customer inquiries, disputes and complaints in a professional and courteous manner. Escalate contentious complaints to supervisor or higher management.
Obtain all insurance, demographic, guarantor information and update patient profile as well as bill third party payers as appropriate.
Meet productivity and quality targets.
High school graduate or GED certificate.
Minimum of 6 months to one year experience in a physician billing or third party payor environment.
Customer orientation and ability to adapt/respond to different types of characters
Excellent communication skills, professional phone manner
Ability to multi-task, prioritize, and manage time effectively
Knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
Ability to work independently.
Some knowledge of electronic billing systems.
Requires passing a system competency assessment.
Functional knowledge of basic computer operation and keyboard functions.
Must be a motivated individual with a positive attitude and exceptional work ethic.
Patient financial and practice management system experience in Epic and or other systems and computer software skills, Microsoft Word, Excel and Outlook, E-mail, etc.).
Medical terminology experience.
Previous call center experience a plus
Previous claims experience
Previous experience in an academic healthcare setting