Patient Billing Customer Service Representative

About This Role

This role involves assisting families and insurance providers with concerns regarding hospital and physician services, utilizing telephone, email, and letters for communication. The representative will document interactions, investigate denied claims, and identify denial trends.

Responsibilities

• Update and process patient registration and insurance information in a timely and accurate manner
• Investigate current insurance eligibility information through web sites established by Third Party Insurance and Governmental Payers
• Review patient accounts that are denied by insurance companies and facilitate further investigation
• Identify denial trends and work with administrators or managers of various Hospital Departments
• Inform leadership of denial trend information and work with them towards a resolution
• Meet with coding representatives to identify and resolve denial trends
• Share information regarding denial trends with Managed Care Department to resolve payment issues at the contract level
• Promote positive internal and external relationships while providing superior customer service
• Perform financial screening of guarantors and assist families with HCAP/Charity applications
• Read/interpret and provide guidance to guarantors related to payer EOBs
• Collect self-pay accounts billed for services, including establishing payment arrangements
• Triage and escalate complaints and patient care issues trending as appropriate

Requirements

• High school graduate or equivalent
• 1 year experience in a physician/hospital billing setting
• Strong interpersonal skills
• Above average communication and organizational skills
• Prior experience in processing personal and confidential data
• Proficiency in utilizing third party and governmental web sites for claims information
• Experience with computerized physician/hospital systems
• Ability to process large amounts of data timely
• Proficient personal computer skills including Microsoft Word and Excel
• Results-oriented and able to work independently to set priorities

Qualifications

• High school graduate or equivalent
• 1 year experience in a physician/hospital billing setting, 3 years preferred

Nice to Have

• 3 years experience in a physician/hospital billing setting
• Thorough knowledge of medical terminology and ICD9/10 CPT coding
• Prior EPIC experience

Skills

* Required skills