Customer Service Billing Representative Hybrid

Customer Service Representative

This position is primarily responsible for a hybrid of customer/patient service telephone, project work, and online interaction for billing inquiries and acts as an ambassador for the Revenue Cycle Management department, providing patient-centric access and service to incoming patient/family calls. The CSRs possess a strong understanding of hospital and/or physician revenue management, including coding processes, billing, insurance follow-up, and appropriate collection practices. Comprehensive knowledge of internal workflow processes and ancillary systems is required to quickly analyze and understand how to resolve incoming patient questions/requests related to various components of billing, including payer adjudication and processes. Strong problem-solving skills are required, including researching documentation and patient account history to help resolve recurring calls. Comprehensive knowledge of UH entity collection and financial assistance policies is required in order to support questions/inquiries from under/uninsured patients. Works harmoniously with staff and teams as appropriate. CSR must remain current with governmental and third-party billing, follow-up, and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities, including internal and external policy requirements. System savviness and proficiency are needed across multiple financial, payer, ancillary, and other applications used in documenting patient account information. CSR supports and is engaged in all consumerism and price transparency initiatives to ensure that exceptional service is provided and financial needs to our patients are consistently met. Engagement and recommendation on further developments of these initiatives is expected as a result of patient interaction. The CSR supports department and leadership with performing department projects, provides financial counseling support, reviews and resolves departmental reports/work lists, as well as other departmental duties as assigned. The position works closely with patients/families, staff, and leadership to coordinate support and handoffs between Pre-billing/billing, Financial Counselors, Customer Service, Self-Pay Collections, and Physician A/R teams to optimize patient experience and collections. The CSR fully understands customer service key performance indicators and works to consistently achieve these metrics including patient satisfaction through survey submission, productivity, average speed to answer, call wait times, and abandon rates, setting performance standards for the department.

What You Will Do:

• Handles inbound and outbound customer calls minimally half the time to resolve inquiries in a timely and accurate manner; in a patient-focused manner that enhances the experience of patients and their families.
• Appropriately research and document all information from phone conversations and applies the appropriate transactions as appropriate to patient accounts.
• Works with internal and external resources as appropriate to support requests needed.
• Process payments by phone via electronic check, credit card, hard copy, payment database, or any other approved means.
• Understand, explain, execute, and help determine eligibility for hospital financial assistance programs.
• Assist patients with payment plan arrangements including collecting initial down payment as part of the process by following established departmental policy.
• Identify patient or customer needs, clarify information, research and analyze issues, and provide solutions and/or appropriate alternatives.
• Maintains patient and physician confidentiality and professionalism in accordance with departmental and HIPAA guidelines at all times.
• Consistently communicates issues and helps to review and implement people, process, and technology improvements as appropriate.
• Performs various duties such as: Research