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Patient Support Representative
2 months ago
Healthcare Partners Investments is seeking a dedicated full-time Customer Service Specialist for our Medical Billing Office.
Work Schedule:
Monday through Friday, with no weekend or major holiday shifts required.
Position Overview:
The Customer Service Specialist plays a crucial role in providing patient support within the Central Billing Office. Responsibilities include managing customer service inquiries, addressing patient concerns, conducting research to resolve queries, establishing payment plans, and performing initial charity screenings. This position serves as a vital link between patients, the Central Billing Office, and our clients regarding patient-related issues.
Key Responsibilities:
- Deliver patient-focused support in accordance with established policies and procedures.
- Demonstrate effective communication skills, both verbal and written, along with proficiency in Microsoft Office applications.
- Thrive in a dynamic work environment with frequent interruptions.
- Comprehend the claim reimbursement process from patient visit to claim resolution.
- Address inquiries related to claim status, whether pending with third-party insurance or patient responsibility.
- Possess in-depth knowledge of third-party payer contracts, processes, and procedures.
- Analyze insurance Explanation of Benefits (EOB) and articulate findings to patients clearly.
- Understand patient payment guidelines and charity criteria for each client.
- Exercise independent judgment to resolve complex account issues, conducting necessary research.
- Correct claim-related issues, including demographic and insurance updates.
- Maintain a professional and positive relationship with patients, healthcare providers, and colleagues.
- Stay informed about changes in rules or policies relevant to the position.
- Achieve proficiency in all systems and processes associated with the role.
- Collaborate effectively with supervisors, coworkers, and clients.
- Follow supervisor directives and maintain workplace harmony.
- Exhibit regular and reliable attendance.
- Perform additional duties as assigned.
- Respond to incoming calls promptly and courteously.
- Return all messages within 24 business hours, excluding holidays.
- Adhere to HIPAA guidelines in all communications.
- Clarify billing inquiries, explain outstanding balances, and resolve customer complaints.
- Assist patients with account payments, budget arrangements, and applicable discounts.
- Provide necessary paperwork upon patient request, following release of information policies.
- Retrieve required documents from various systems as needed.
- Process payments via credit card or check over the phone, forwarding to the appropriate department.
- Update demographic and insurance information based on patient input.
- Request claim re-filing when necessary and follow up on additional actions required.
- Conduct initial charity screenings and send applications to qualifying patients.
- Respond to patient correspondence via phone or mail, referring to other departments as needed.
- Contact clients for required information and ensure timely follow-up.
- Escalate unresolved claim issues to the appropriate team or manager promptly.
- Communicate all patient complaints to the Customer Service Manager for tracking and reporting.
- Document all actions taken on accounts in the appropriate system notes.
- Record all activities performed on patient accounts in the billing system.
- Ability to manage multiple tasks, including extensive phone interactions and familiarity with various billing systems.
- Minimum of 2 years of experience in healthcare customer service, billing, or collections, with knowledge of insurance processes.
- Experience with current systems is preferred.
- Bilingual skills are a plus but not mandatory.
- High School diploma or equivalent is required.
- Comprehensive medical coverage with minimal out-of-pocket expenses.
- Dental options that maximize savings and reduce costs.
- Access to a vast network of vision care providers.
- Flexible spending options for medical and dependent care expenses.
- Company-paid life insurance with options for additional coverage.
- Long-term disability coverage after a qualifying absence.
- Short-term disability options available for purchase.
- 401(k) plan with generous matching contributions.
- Accrual of paid time off and paid holidays.
