The Customer Service Representative is responsible to successfully handling all incoming patient phone calls. This person must be able to answer all patient questions regarding their account balance and other general statement questions. They will route any detailed account concerns to the appropriate Physician Billing Specialist for further work, correspondence and/or resolution. This position must portray the utmost professionalism and courtesy, and represents the voice of the Physician Billing Services department.
Duties & Responsibilities:
Provide professional and courteous service to all customers
Communicate effectively in written and verbal form
Maintain clean, well-organized, properly stocked and secure working area
Maintain complete patient/employer confidentiality at all times per company and HIPAA requirements
Perform job functions in accordance with current departmental Standards, Polices and Procedures
Accommodates changes in workload within the department
Keeps supervisor informed when problems may interfere with work being completed on time.
Use initiative to resolve problems with appropriate action and follow through
Responds to incoming calls within 3 rings in a professional, friendly and courteous manner.
Maintain HIPAA compliance by verifying the patient identity using two (2) forms of identification. If the patient is not the caller, verify the caller is listed as an authorized point of contact for the account. Acceptable forms for verification include last 4 digits of SSN, date of birth, etc. Notes should include that verification was obtained.
Efficiently triage the call by locating the patient account and understanding questions/concerns.
Document the details of the patient’s phone call and their concern accurately as instructed according to department standards, policies and procedures.
Review accounts thoroughly, making all necessary corrections as needed.
Follow up on patient’s issues promptly and return calls in a timely manner.
Forward any unanswered concerns or questions to the appropriate patient account representative, insurance specialist or medical group representative while establishing correct expectations with the patient as to an expected return phone call or resolution, according to department standards, policies and procedures.
Demonstrate the ability to handle difficult patient’s with professionalism and effectively resolve patient’s misunderstandings.
Research and process patient refunds and credit balance adjustments as assigned in a timely manner and according to department standards, policies and procedures.
Qualifications & Experience:
Minimum two (2) years’ experience in patient account billing and collections.
General computer skills, including the ability to use the internet and learn other computer applications.
Excellent problem solving skills.
General knowledge of medical terminology and ICD9 coding.
Working knowledge of general medical office procedures required.
Working knowledge of legal aspects of patient and insurance collections.
40 WPM typing, verifiable
10 key by touch
Must have good listening skills and the ability to communicate clearly and effectively.