PBS Specialist - Customer Service

Healthcare/Business Support

The PBS Customer Service Specialist is responsible for creating a positive patient experience while interacting with customers regarding patient inquiries in a high-volume call center and/or in person. The Specialist will work to review and resolve patient inquiries, complaints and grievances by phone, via MyChart, via Zoom and in writing in a courteous and professional manner that is both caring and compassionate. This individual maintains positive working relationships with our internal and external customers and vendors. The Specialist will provide details regarding billing inquiries and needed information, such as itemized statements and patient account summaries in our electronic health record (EPIC).

Specialists also manage estate and bankruptcy processes for referral to the Office of General Counsel, in addition to referral and review of accounts in bad debt. The Specialist must be able to utilize critical thinking skills to analyze problems and review and resolve billing inquiries and complaints. This individual must be able to multi-task in a fast-paced environment and will need exceptional customer service skills, appropriate phone etiquette and a willingness to serve others. The Specialist will need a working knowledge of healthcare billing (hospital and physician) and the ability to review and explain how claims processed according to the Explanation of Benefits. This individual needs to be comfortable discussing and collecting patient balances.

Specialists will need to adhere to all department's policies and procedures. The Specialist will work under the guidance of the Patient Business Center Customer Service Supervisor and will be responsible for timely escalation of patient concerns to the Supervisor for resolution.

Key Functions

1. Manages a high volume of complex inquiries in EPIC and resolves concerns within 24-48 hours.

2. Utilizes critical thinking skills not only to make judgements on accounts but also to ensure that patients concerns are addressed fully.

3. Work with Patient Advocacy to address patients' concerns.

4. Address correspondence and MyChart requests and follow up with patients within 24-48 hours

5. Load/Link insurance information

6. Review accounts during interactions to ensure all demographic information is valid and up to date

7. Review accounts for possible refund due and communicates any refund request to the Credit Resolution Team.

8. Must be able to perform analysis on all accounting systems assuring billing of total charges, verification of payment postings, contractual adjustments and report valid account information.

9. Always Adheres to the ABC's of customer service by adhering to the greetings established for the department.

10. Receives and responds to incoming calls from providers and representatives from insurance companies providing information necessary to expedite claim processing and resolution.

11. Follows up on aged balances identified during each encounter with patients and work towards immediate resolution.

12. Reviews the patients accounts in its entirety to resolve the complete account; undistributed balance, aged balances, refund pending.

13. Must have excellent written and oral communication skills.

14. Advises patients of all aged balances and attempt to collect.

15. Maintain all assigned work queues by not lagging beyond 30 days with no follow up activity documented.

16. Completes payment plan request timely and accurately according to the guidelines established by the department.

17. Achieves the annual collection goals established by the department.

18. Work independently and deal effectively with stress as a result of heavy workload and the handling of complex patient inquiries.

Education and Experience

Education Required: Associate's degree in Business Administration or related field.

Education Preferred: Bachelor's degree in Business Administration or related field.

Required Experience: Four years of experience in healthcare to include two years' experience billing, governmental regulations and/or claims adjustment. May substitute required education degree with additional years of equivalent experience on a one-to-one basis.

Preferred Experience/Skills: Five years of healthcare experience in customer service, experience working in a call center in healthcare related, billing, insurance follow-up, collections, cash posting, credits resolution, or bad debt management in medical or hospital business office setting.

Other Requirements: Must pass pre-employment skills test as required and administered by Human Resources. The University of Texas MD Anderson Cancer Center offers excellent benefits, including medical, dental, paid time off, retirement, tuition benefits, educational opportunities, and individual and team recognition. This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment. It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state, or local laws unless such distinction is required by law.