Customer Service Representative I

Department:

Status:

Benefits Eligible:

Hours Per Week:

Schedule Details/Additional Information:

Pay Range

Job Summary

Customer Service Representative I serve as the first point of contact for the customer service issues and resolves a high volume of patient inquiries regarding both hospital and professional billing questions.

Essential Functions

• Delivers an exceptional Patient Financial experience by receiving and directing the public, by telephone or other electronic means, in a professional and courteous manner and with consciousness and sensitivity to the diversity of the organization and its patients' needs.
• Manages a high volume of inbound calls, answers patient inquiries, and determines the appropriate path for resolution and follow-up.
• Demonstrates excellent customer service and expertise to patients, guarantors, and other external and internal contacts through oral and written communication.
• Responds to and documents all patient and internal inquiries regarding hospital and professional visits in the patient billing platform as they relate to the patient financial experience.
• Understands varying business processes and procedures of both the Physician Billing Office and Hospital Billing Office and is able to evaluate the most appropriate route for account resolution.
• Reads, interprets, and understands various differing insurance correspondence including both explanation and coordination of benefits.
• Demonstrates a basic understanding of varying different reimbursement terms across multiple payers and benefit plan types (HMO, PPO, Indemnity, HDHP) in both the Physician Billing and Hospital Billing landscape and how those terms may affect the responsible party's benefits and subsequent balance(s).
• Demonstrates a basic understanding of the standard healthcare coding methodologies, including, but not limited to CPT, HCPCS and ICD-10.
• Performs all clerical functions required to complete a request using available information and resources. Coordinates to resolve issues requiring follow- up with the appropriate team, insurance companies, attorneys' offices and other departments.
• Performs appropriate updates to insurance coverage, demographic information and contact information in patient billing system.
• Performs analysis of the responsible party's outstanding balance and provides consultative services to establish the most efficient and effective account resolution that meets the needs of the patient while also protecting the financial viability of Atrium Health.
• Prompts guarantors to pay outstanding balances over the phone using a credit or debit card, provides the lockbox mailing address for physical checks or initiates monthly payment arrangements for patients through Atrium Health's third-party partner.
• Responsible for meeting and maintaining Productivity measures and Quality Assurance goals as established by the Customer Service Department.

Physical Requirements

Work requires most of the time spent sitting, however, the work does require some walking. Work requires heavy telephone use and interaction with patients, family members, other departments, and outside sources. Requires minimal standing to file documents and do research. Must be able to reach and bend on a moderate level.

Education, Experience and Certifications

High School Diploma or GED with 2 years relevant customer service experience, or bachelor's degree preferred. 2 years progressive work experience in a hospital billing, professional billing or shared services environment preferred. Experience with Epic's Resolute Hospital or Resolute Professional billing applications preferred. Working knowledge or professional and hospital billing and follow-up preferred. Knowledge of HIPAA standards and medical terminology and billing practices preferred. Bi-lingual (Spanish and English) preferred.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

About Advocate Health 

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.