Under the leadership of Central Business Office (CBO) management, the Customer Service Specialist provides supportive assistance to patients regarding billing concerns/issues. This position is responsible for answering incoming phone calls from patients and resolving billing concerns in a timely, accurate manner.
The Customer Service Specialist will have many customers, but primarily patients. It is expected that the Customer Service Specialist will foster positive relationships with all customers in an effort to provide quality service.
This position provides support and assistance to CBO management as directed. The Customer Service Specialist is expected to remain in full compliance with all departmental, institutional and regulatory policies and procedures at all times. The roles and responsibilities of this job support the mission, vision, values and strategies of Mercy Health.
Essential Functions & Responsibilities:
It is expected that all of the Principal Duties and Responsibilities identified below will be performed in a manner that reflects the values of the Catholic Healthcare Partners, which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service.
- Provides supportive assistance to patients regarding billing concerns/issues
- Answers incoming calls from patients and returns calls, addressing patient’s questions or concerns in a professional and ethical manner
- Interacts with patients, family members, external healthcare related companies, law firms, co-workers and other MH employees to resolve billing issues or concerns
- Assesses the nature of incoming calls and identifies and completes appropriate action in a prompt manner. Activities may include:
- Research specific transactions on a claim
- Re-send patient statement
- Re-bill a claim
- Add or change insurance information
- Verify eligibility on account
- Pull an explanation of insurance benefits for payment information
- Request adjustment on a claim
- Send itemized statements
- Send a Financial Aid Application to a patient or refer to Financial Counseling, as appropriate
- Direct customer to the appropriate responsible party to resolve concerns outside the CBO, as needed
- Post comment(s) into CarePATH documenting patient’s concern and the actions taken
- Reviews incoming patient correspondence
- Understands all key processes in the CBO including activities related to billing, collections/follow-up, posting and customer service and how their actions impact the Revenue Cycle
- Organizes work/resources to accomplish objectives and meet deadlines
- Maintains compliance with federal, state and local regulations, HIPAA and the Corporate Responsibility Program
- Maintains the privacy and security of all confidential and protected health information. Uses and discloses only that information which is necessary to perform the function of the job
- Demonstrates the willingness and ability to work collaboratively with other key internal and external staff to obtain necessary information to address customer service matters
- Reports issues and trends to appropriate management personnel in CBO and works collaboratively to develop solutions
- Participates in all educational activities and demonstrates personal responsibility for job performance
- Uses supplies and equipment effectively and efficiently
- Consistently demonstrates a positive and professional attitude at work
- Maintains stable performance under pressure and handles stress in ways to maintain relationships with patients, customers and co-workers
- Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations
- Maintains satisfactory attendance and punctuality record as set forth by Mercy Health policies
- Responsible for other relevant work functions, as requested
Qualifications - Minimum
Knowledge, Skills & Experience Required:
- High School diploma or GED required. Associate’s Degree, graduate of Business College or 1 year college preferred with additional business courses, including medical terminology, typing and word processing.
- Minimum of 2-3 years business office experience in a physician practice environment.
- Previous customer service experience in a hospital or physician practice is preferred.
- Excellent phone etiquette and internal/external customer service skills required.
- Microsoft Word and Excel experience preferred.
- Demonstrate in-depth knowledge and experience in the following technology solutions: patient accounting, optical imaging, scanning, and internet-based insurance websites.
- Knowledge of insurance companies and their payment practices is preferred.
Monday - Friday
8:30 am - 5:30 pm
Equal Employment Opportunity
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.