Patient Service Representative II | PSR's | Days | Full-Time ID - 11343
Job Description
JOB DUTIES
Responsible for answering incoming calls on an Automatic Call Distributions (ACD) system regarding the patient’s statement, which includes hospital and physician services. Research, facilitate and resolve simple to complex billing issues and communicate the findings to the caller. Address any questions or requests regarding their account, educate patients on insurance and medical billing processes, make any needed corrections the account.
Essential Functions
• Promptly answer inbound calls in a call center environment from patients, attorneys, insurance reps, clinic staff, and outside medical facilities to provide professional and timely customer service.
• Research and respond to call and written physician and hospital account inquires and requests via inbound calls, the EPIC MyChart portal and in-person.
• Verify insurance eligibility and update the patient registration, which includes filing or re-file of claims to insurance for payment.
• Facilitate to a resolution patient billing disputes and request including communicating key information to other department management personnel as needed. Send timely follow up communication to ensure the necessary actions are completed.
• Collect payments over the phone and in person. Reconcile daily Cash sheets and submit them timely for review and processing.
• Review and interpret electronic remits and EOB’s to verify the account balances are correct. This includes making appropriate insurance adjustment corrections and researching denial reasons.
• Review and interpret visit and procedure chart notes to address billing disputes and inquiries regarding ICD-10 and CPT coding data elements to facilitate corrections.
• Communicate via outbound calls, emails and letters to provide the status or resolution of the billing issue or request.
• Provide requested billing records to patients and Attorneys per HIPAA guidelines and company policy.
• Assist patients with meeting their Medicaid share of cost and file claims to Medicaid when eligible.
• Review and correct self-pay discounts or package pricing discounts as needed. • Research and facilitate the processing of insurance and patient payment credits for refund. • Meet the established individual and team goal standards using the required call and account tracking functions. • Meet established attendance requirements as outlined by the company attendance policy and department requirements.
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Temperament
Must be able to perform under stress when confronted with emergency, critical, or unusual situations. Must be capable of dealing with periodic cyclical workload pressures and levels of responsibility. Required to make independent judgments without supervision. Must be able to make generalizations, evaluations, or decisions based on sensory or judgmental criteria. Must have the adaptability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure. Requires the ability to work with people beyond giving and receiving instructions.
Qualifications
SKILLS, QUALIFICATIONS, AND REQUIRED EXPERIENCE
Skills, Knowledge, Abilities
• Ability to provide dynamic customer service using various techniques including positive language, calming presence, attentiveness, clear communication, and patience.
• Ability to communicate effectively and courteously, both orally and in writing.
• Concisely communicate and relate to all levels of the organization, customers and outside agencies.
• Computer literate with proficiency in Microsoft Office (Outlook, Word, Excel, Access, and Power Point), Adobe Acrobat, 10-key, and database management.
• Ability to organize and prioritize assignments to work independently as well as a collaborative team member.
• Strong team orientation.
• Verifying eligibility via Internet web-sites.
• Attention to detail and quality of work.
• Self-directed with sound judgment and able to adapt quickly, handling multiple, competing tasks with appropriate prioritization.
• Ability to deal with stressful situations and maintain professional demeanor.
Experience Requirements
Length of Experience Type of Experience Required/Preferred
3 years Physician Medical billing including follow-up, and registration preferred
2 years Customer Service, preferably in a phone center environment preferred
Up to 1 year Personal computer including Microsoft Office (Outlook, Word, Excel) preferred
Up to 1 year Medical billing software (Epic) preferred
Education Requirements
Degree/Diploma Obtained Program of Study Required/Preferred
High School Diploma or GED equivalent
