Medical Customer Service Agents: Patient Accounts Services
The Customer Service Representative is the organizations liaison between patients, patients' relatives, and the healthcare organization; handles patients' questions, complaints, problems and concerns.
Explains policies and procedures to patients and refers them to the proper services required.
Familiar with a variety of the field's concepts, practices, and procedures, including patient and insurance billing.
Relies on extensive experience and judgment to plan and accomplish goals.
The core responsibilities of a Customer Service Representative are answering in and out bound calls, research, insurance and adjustment identification to ensure proper account resolution.
This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience and flexibility.
Customer Service Representatives rely on guidelines established by the organization to perform job functions and work under general supervision in a moderately fast paced environment.
Customer Service Representatives usually report to the department lead or supervisor.
EDUCATION & WORK EXPERIENCE: High school diploma or equivalent.
A minimum of 1 year previous work experience as a customer service representative is required.
Must have full understanding of customer service and insurance follow-up processes (ie Billing a+, Collections, Managed Care, Medicare, Medicaid and Commercial Practices), and well developed inter-personal skills.
REQUIRED JOB KNOWLEDGE & SKILLS: Excellent verbal and written communication skills Reliable attendance record Knowledge of EOBs, CPT & ICD-9 codes, HCFA;s, UB92s, HCPCS, DRGs and authorizations/referrals Good problem solving skills Ability to learn / stay abreast of relevant policies Computer literate / able to use basic functions of a computer Ability to type a minimum of 30 wpm Detail oriented and well organized Outstanding listening skills Ability to perform under pressure in a calm manner Basic math skills High degree of accuracy Positive attitude Flexible Team player CORE RESPONSIBILITIES & JOB FUNCTIONS: Core responsibilities include but are not limited to the items listed below: · Provide Patient Friendly Customer Service · Review, Interpret Patient Statements, Balance and Client Contractual Terms/Agreements · Obtain Supporting Documentation Regarding Patient/Client Follow-up Efforts · Identify Contractual & Administrative Adjustments · Outbound Call Dialing
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