Job Description
The Customer Service Specialist contributes to the achievement of service delivery, performance standards, and financial targets by:
- Being available to assist customers by closely adhering to set schedules and handle time standards.
- Treating customers with compassion and respect as well as protecting their privacy.
- Taking initiative to secure payment or resolve account balances.
The functions described in this position description carry out the Mission, Vision, and Core Values of HealthServicesNW (HSNW) by ensuring that all healthcare services provided at the facility are billed and paid both accurately and timely. These functions are performed in accordance with applicable laws and regulations, and HSNW policies and procedures.
KEY WORKING RELATIONSHIPS
Successful accomplishments and primary accountabilities of this position will depend upon establishing and maintaining effective working relationships with a variety of people both inside and outside of the functional area. Such people may include but are not limited to: interdepartmental leadership, the education and development team, the patient, client hospital staff, insurance company representatives, vendors, compliance, finance, decision support and contract management, as well as HSNW Senior management and staff.
KEY POSITION ACCOUNTABILITIES
- Handle calls to and from patients, insurance companies, clients and various other sources to bring about prompt account resolution.
- Take the initiative to secure payment or resolve account balances, contributing to the achievement of financial targets.
- Pre-screen patients for potential financial assistance eligibility and follow through with initiating the appropriate paperwork.
- Analyze billing issues and patient questions to determine next course of action such as updating status codes and fiscal fields.
- Log and resolve lower level patient complaints and refer more complex complaints to dispute coordinators.
- Research payment discrepancies by retrieving documents and coordinate appropriate corrections.
- Request adjustments in line with company guidelines and approval authority limits.
- Maintain accurate, clear, concise, and complete account information in HSNW primary system.
- Promote HSNW as a premier service organization by treating customers with compassion and respect and ensuring that service delivery targets are met.
- Closely adhere to set schedules and handle time standards.
- Report recurring problems.
- Maintain confidentiality of all patient demographic, medical, and financial information. Maintain confidentiality of all HSNW and client information. Ensure proper handling and disposal of confidential documents and adherence to all HIPAA rules and regulations.
- Comply with all applicable Federal, State, and local laws, regulations, and requirements as well as HSNW policies and procedures in all aspects of job performance.
Job Requirements
ESSENTIAL POSITION EDUCATION, EXPERIENCE, COMPETENCIES AND REQUIREMENTS
Education:
High School Diploma or GED equivalent required.
Experience:
Two years experience in call center, billing, collections or financial industry required. Hospital collections experience highly desireable.
Certifications:
CPAT preferred.
Knowledge, Skills, and Abilities:
- Proven comfort level in discussing financial situations and taking initiative to ask for payment.
- Proven effective telephone skills with the ability to listen, speak clearly and communicate respectfully to customers.
- Demonstrated ability to type 40 wpm with 98% accuracy while handling telephone calls.
- Proven ability to analyze, research and problem solve.
- Proven strong attention to detail with a focus on quality.
- Proven ability to work collaboratively in a team environment in a positive and professional manner.
- Demonstrated ability to perform in alignment with company mission and values.
- Basic knowledge of the Fair Debt Collections Practices Act.
- Basic knowledge of ICD-9/CPT coding, medical terminology, federal and state medical programs, billing procedures.
- Proven PC Proficiency in MS Windows and Office applications. Knowledge of call center technology and applications is preferred.
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