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Customer Service Account Specialist

1 month ago

Galveston, Texas, United States UTMB Health Full time
Job Summary: As a Customer Service Account Specialist at UTMB Health, you will play a critical role in resolving patient inquiries and concerns related to Physicians' Billing Services (PBS) and Hospital Patient Financial Services (HPFS) patient accounts. You will serve as a liaison between various departments, insurance companies, and patients to ensure efficient and patient-friendly resolution of medical reimbursement issues.

Key Responsibilities:

• Respond to patient inquiries and complaints via phone, email, web, and correspondence regarding their PBS and/or HPFS accounts.

• Communicate complex insurance information to patients through verbal and written communication.

• Verify patient eligibility for coverage with government programs and commercial insurance.

• Serve as a liaison for patients in contacting third-party payers regarding their questions.

• Utilize knowledge of third-party payers and informational tools to assist patients in understanding payer benefits and methodologies.

• Effectively communicate with clinical departments and personnel to ensure efficient handling of patient inquiries from inception to completion.

• Determine and effect adjustments to patient accounts (PBS and HPFS) as necessary.

• Determine and effect refunds to patient accounts (PBS and HPFS) as necessary.

• Review and resolve credit balance patient accounts from various work lists.

• Identify trends from account reviews and effect changes to prevent reoccurrence of problems.

• Identify, investigate, resolve, and escalate, when necessary, payer, system, or clinical departmental billing problems.

• Use various work lists and reports to resolve patient account issues, including bad address accounts and delinquent accounts to be referred to outside collection agencies.

• Contact patients with outstanding balances by phone to attempt to secure payment or establish a payment plan.

• Appropriately document patient accounts with the nature of the inquiry or contact and the action taken.

• Remain compliant with HIPAA regulations at all times.

Requirements:

• High School diploma and 4 years of experience in a patient account environment or related field.

• Strong communication and interpersonal skills.

• Ability to work in a fast-paced environment and prioritize multiple tasks.

• Strong analytical and problem-solving skills.

• Ability to maintain confidentiality and handle sensitive information.

Salary Range: Actual salary commensurate with experience or range if discussed and approved by hiring authority.

Work Schedule: 8am to 5pm, and as needed on occasion.

Equal Employment Opportunity UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans, and individuals with disabilities.