Customer Service Representative

Overview

Job Summary:

• Supports patients with billing concerns under Patient Financial Services (PFS) management.
• Answers incoming calls and resolves billing issues promptly and accurately.
• Performs specialized duties and assists management with daily activities.
• Maintains thorough knowledge of department tasks to cover for absent team members.
• Assists in developing training materials to ensure process accuracy.

Education/Experience:

• High school diploma or GED required.
• Two years of customer service experience required.
• Two years of business office experience in a physician practice or hospital preferred.

Licensure/Certification:

• Not applicable.

Essential Functions:

1. Assess and resolve incoming calls regarding billing issues promptly.
2. Handle tasks such as researching claims, re-billing, updating insurance, verifying eligibility, and documenting actions in Epic.
3. Provide direction and serve as a resource for team members.
4. Research complex accounts and questions.
5. Prioritize workload based on management guidance and meet deadlines.
6. Understand key PFS processes and their impact on the Revenue Cycle.
7. Assist in developing training materials.
8. Maintain compliance with regulations, HIPAA, and Corporate Responsibility Program.
9. Protect confidential health information.
10. Report issues and trends to management and collaborate on solutions.
11. Participate in educational activities and demonstrate job performance responsibility.
12. Comply with corporate and departmental policies, quality improvement, customer service, and productivity expectations.
13. Maintain satisfactory attendance and punctuality.
14. Perform other relevant duties as requested.

Skills/Qualifications:

• Excellent phone etiquette and customer service skills.
• Ability to work independently.
• Positive and professional attitude.
• Stable performance under pressure.
• Effective oral and written communication skills.
• Strong computer and math skills, knowledge of Excel required.
• Leadership abilities.
• Extensive knowledge of Medicare, Medicaid, and third-party insurance guidelines.
• Independent judgment in unusual or stressful situations.
• In-depth knowledge of patient accounting, optical imaging, scanning, patient systems, and internet-based insurance websites.

Work Environment:

• Clean, comfortable office environment.
• Potentially stressful work.
• Interaction with upset individuals.
• Flexibility to provide staffing assistance in emergencies.
• Manage exposure to infectious material per OSHA guidelines.

Physical Requirements:

• Standing: Up to 35%
• Walking: Up to 35%
• Sitting: Up to 65%
• Bending: Up to 35%
• Reaching with arms: Up to 35%
• Finger and hand dexterity: Up to 65%
• Talking: Up to 65%
• Hearing: Up to 65%
• Seeing: Up to 65%
• Lifting, carrying, pushing, pulling:
  • 20 lbs. maximum
  • 50 lbs. maximum
  • 100 lbs. maximum