Customer Care Rep I

ROLE SUMMARY

In a high-paced environment; receives inbound and makes outbound calls to patients, reviews patient accounts to answer questions, communicates payment options and assists with taking payments on the phone utilizing billing systems. Will answer questions on insurance payment and verify demographic information.

CORE RESPONSIBILITIES

• Provides in-depth review of patient account information to answer questions regarding patient responsibility, account billing status, insurance information and charges.
• Summarizes and documents patient calls
• Communicates and transfers information to clinics and other departments as applicable for resolution.
• Works patient correspondence, updates information, audits accounts and mails out requested information.
• Ensures all workflow items are completed within the set turn-around-time and quality expectations.
• Develops, maintains, and conducts standard work for complex accounts including, but not limited to, legal authorizations, probate, bankruptcy and settlement offers.
• Develops, maintains, and conducts standard work for daily, weekly, and monthly reconciliation of accounts placed with external collection agencies.
• Develops, maintains, and conducts standard work for posting adjustments and refunds for accounts.

The above statements are intended to describe the general nature and level of work performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of personnel so classified and employees may be required to perform other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

• Ability to communicate effectively with internal and external clients
• Ability to use good judgment and critical thinking skills to identify and resolve problems
• Proficient skills in MS Office software; particularly Excel and Outlook
• Computer and telephone knowledge
• Efficient and accurate keyboard/typing skills
• Ability to exhibit a high level of professionalism with a strong work ethic and commitment to satisfaction
• Functional knowledge of HIPAA rules and regulations
• In-depth working knowledge of the various applications associated with the workflows

MINIMUM REQUIREMENTS

• High school diploma (or Equivalent Certificate from an accredited program) or higher degree
• Six (6) months or more of customer service and/or monetary transaction experience

PREFERRED QUALIFICATIONS

• Call center experience
• Bilingual Spanish
• Coding and billing certification
• Experience with privacy laws, access and release of information