Customer Service Specialist

1 week ago

New Haven Connecticut, United States Yale New Haven Health Full time

Overview:


At Yale New Haven Health, we are committed to our Vision, Mission, and Values. Every team member is expected to embody our core principles of integrity, patient-centered care, respect, accountability, and compassion in their daily activities.


As a Customer Service Specialist, you will engage with a diverse range of customer inquiries in a dynamic call center setting. Your role will involve managing patient accounts and ensuring that all information regarding third-party coverage is accurate and up-to-date.

You will oversee the workflow of other team members to facilitate effective resolutions. Handling a substantial volume of patient calls, you will analyze third-party information and coverage issues to ensure the proper application to patient accounts.

Adhering to HIPAA verification protocols is essential to confirm that you are communicating with the correct individual before disclosing any information.

Your responsibilities will include taking decisive actions to resolve account discrepancies while upholding the hospital's commitment to exceptional customer relations.

Additionally, you will research and investigate patient inquiries, directing them to the appropriate resources or following up to ensure their concerns are addressed.

This role requires coordination of information from patients, clinical departments, government entities, and insurers to reconcile accounts effectively. Attention to detail and strong analytical skills are vital for resolving complex patient inquiries. You must balance excellent customer service with the need to manage calls efficiently to meet high demand.

Knowledge of federal and state regulations, including the Fair Debt Collection Practices Act, is necessary when discussing payment options with patients.

Fluency in Spanish is preferred.

EEO/AA/Disability/Veteran

Responsibilities:

  • Manage a high volume of incoming calls in a call center environment, addressing patient and third-party inquiries to ensure accurate account information and coverage details. Identify necessary corrective actions and document all interactions in the system. Collaborate with other staff members to expedite account resolutions and respond promptly to patient needs.
1.1 Assess the nature of inquiries upon call reception, as monitored by the supervisor.

  • Evaluate problematic accounts and correspondence, providing callers with a seamless experience. Address complex mail responses that require corrective action to ensure effective billing and facilitate workflow.
2.1 Provide necessary documentation within forty-eight (48) hours to resolve administrative complaints and update the system accordingly.

  • Enhance personal knowledge by staying informed about billing and payment policy updates, attending meetings and seminars to effectively fulfill assigned duties.


3.1 Review all memos and policy updates distributed by the supervisor to ensure compliance with current billing procedures.


  • Promote the Patient-Centered Care Concept throughout the organization. Participate in workgroups to analyze, identify, plan, develop, and implement improvements to enhance departmental performance.


4.1 Engage in ongoing training to ensure a comprehensive understanding of departmental procedures and communicate any changes to staff as they relate to this service line.


Qualifications:

EDUCATION
High school diploma with business-related coursework; an associate's degree is preferred. Certification as a Customer Experience Professional (CCEP) through the Customer Service Institute of America (CSIA) is required or must be obtained within six months of hire.

EXPERIENCE
Two years of customer service experience in a fast-paced environment; one year of experience in processing healthcare claims is preferred.

LICENSURE


Certification as a Customer Experience Professional (CCEP) through the Customer Service Institute of America (CSIA) is required or must be obtained within six months of hire.


SPECIAL SKILLS


Demonstrated strong customer service skills with the ability to resolve complex issues efficiently. Proven ability to build strong relationships to provide the highest level of customer service. Excellent oral and written communication skills, with the capacity to convey complex requirements across clinical and financial areas. Resourcefulness in managing multiple tasks and priorities in a fast-paced environment. Proficient in PC applications, keyboarding, and navigating various software and spreadsheet systems. Spanish speaking preferred.

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