Customer Service Representative

12 hours ago


Valhalla, New York, United States WMC Health Network Full time

The Customer Service Representative is responsible for managing the day-to-day operations of the call center. This role involves resolving patient concerns and inquiries related to hospital and physician bills. The representative will work closely with the Directors of Patient Relations to resolve complex patient complaints involving quality of care issues.

Key Responsibilities:

  • Follow up and resolve outstanding issues related to insurance questions and payments.
  • Coordinate with other departments to expedite the resolution of patient issues.
  • Notify management of escalating issues and potential trends in call types or customer complaints.
  • Ensure timely resolution of customer inquiries and complaints related to patient accounts.
  • Arrange for Financial Assistance-Charity Care according to Federal and NYS regulations as necessary.
  • Operate multiple patient information systems to resolve complex accounts.
  • Manage estate checks and deceased patient account resolution.
  • Address inquiries from multiple sources, including attorneys, insurance companies, patients, and BSHSI Centers of Excellence.
  • Retrieve and interpret payment documents from insurance companies and other sources.
  • Ensure the appropriate revenue cycle flow is followed to optimize customer service and reduce patient liabilities.
  • Ensure patients are aware of all financial assistance programs and coordinate with vendors to provide maximum assistance.
  • Coordinate with the Billing Center of Excellence for situations requiring re-billing, additional reviews, or edits to claims.
  • Offer patients monthly payment solutions when needed and facilitate the setup of Charity's self-pay vendor.
  • Follow all HIPAA rules and regulations.

Qualifications/Requirements:

  • 3-5 years of experience in a hospital customer service, call center, billing, or follow-up role.
  • High school diploma or equivalent preferred or meets experience requirements.
  • N/A for licenses/certifications.
  • N/A for special requirements.


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