CUSTOMER RESOLUTION SPECIALIST
LONG TERM CONTRACT
PALO ALTO, CA
Option 1 Staffing is an award winning, local, recognized leader in staffing and recruiting, specializing in placing the highest caliber of Non-Clinical Healthcare, Information Technology, Supply Chain, Administrative/Office and Accounting/Finance professionals in contract and direct-hire opportunities. We work with top and emerging companies in the Technology and Healthcare industry.
Are you ready to work at a top hospital in the country? Apply Now!
Top 9 Needed Qualities:
- Medical termination (EOB, COB, Deductible, Co-insurance, in-network, out-of-network etc)
- Customer Service
- Fast Learner
- Team Player
- Problem solver
- Adapts well to change in a fast pace environment
***EPIC is a plus
Hours: 8:00am-5:00pm Monday-Friday with an hour lunch
- Responsible for performing customer care activities in accordance with applicable Federal, State and local standards, guidelines and regulations. These responsibilities include but are not limited to customer service, billing and/or patient account balance collection activities associated with the hospital and professional revenue cycle.
- Responsible for providing excellent customer service to patients seeking information from the business office and general administrative duties related to patient billing that will facilitate improved revenue.
- The Specialist handles a high volume of inbound and outbound calls and must operate with a high level of professionalism.
- The Customer Service Resolution Specialist is knowledgeable in the full scope of medical billing and is empowered to make decisions independently regarding patient financial responsibilities in accordance with departmental policies.
- The individual exerts a strong ability to deal with difficult customers, and has ability to de-escalate callers to enhance the productiveness of the call and increase customer service quality, while finding resolution to the caller’s concern.
- The Customer Service Resolution Specialist will mainly utilize the Epic application. This application is used to house the patient’s electronic medical record, including information regarding appointments, demographics, and patient billing information. The Specialist is knowledgeable within multiple registration and billing applications and will navigate across multiple applications during the duration of a call to troubleshoot an account.
- The Specialist has the ability to identify any workflow or process discrepancies within the invoice and can communicate them effectively to leadership team.
Inbound & Outbound Calls:
- Customer Service Resolution Specialist are responsible for receiving all incoming calls on the ACD (AutomatedCall Distribution) telephone system. Perform timely and efficient collection of all PB and HB self-pay balances.
- The Specialist makes outbound calls to patients with self-pay accounts balances that are due for payment.
- Evaluates the financial situation of the patient being insured vs uninsured. Arranging a method of payment for services rendered, the Specialist works within the financial limitations the patient may have. After determining the income, debts and insurance coverage of a patient, the Specialist communicates the SHC policies and procedures with regards to payment or financial assistance.
- Registration and Demographic Updates
- Update patient demographic or insurance information.
- Has the knowledge and ability to verify eligibility and bill claims to updated health plan.
- Identify and confirm balances that are patient responsibility and advise patient accordingly. If patient has a dispute or patient complaint the Specialist has the ability and knowledge to handle these types of patient concerns and notifies area Manager if needed. Identifies discrepancies with payments or adjustments within an invoice and the ability to discuss the account with the patient. May offer and create payment plans with patients regarding their balances, if applicable.
- Ability to obtain patient payment over the telephone.
- Contacts and notifies health plans as needed for follow up to patient contact
- Work is performed in accordance with established schedules and procedures, however employees are expected to prioritize assignments, adjust schedules or alter sequence ofsteps as necessary to obtain desired result.
- Ability to identify problems and seek solutions using appropriate resources.
- Identifies appropriate areas for professional growth and attends continuing education classes throughout the year
- Performs or requests adjustments and contractual write offs as applicable
- Maintains a thorough understanding of hospital and professional billing procedures and payment practices of state, federal and all third party payers.
- Resolves HB and PB customer service inquiries which could include:
- Benefit and eligibility information
- Billing and payment issues
- Authorization for treatment
- Explanation of benefits (EOB)
- Perform timely and efficient collection of all HB and PB self-pay balances by calling patients/guarantors and others to collect or arrange budget plan options and resolve issues.
- Performs presumptive charity determinations as applicable.
- Performs bad debt request transfers as applicable.
- Ensures daily productivity standards of assigned accounts are met and posting of all action codes related to patient’s accounts
- Maintains a thorough, practical understanding of departmental established policies and procedures
- Participates in organization or department projects as assigned
- Education: High School diploma or GED equivalent
- Experience: Three (3) years of progressively responsible and experience in healthcare setting, with physician practice or facility/outpatient setting is preferred
- HFMA Certified Revenue Cycle Representative (CRCR) certification preferred.
Knowledge, Skills, and Abilities:
• Government/non-government payer requirements, reimbursement rules, laws and regulations that
govern billing/collection activities
• Medical terminology, CPT-4, ICD-9, HCPCS, modifier coding and how these items drive reimbursement
• Knowledge of Medicare, Medi-Cal, commercial and managed care insurance preferred
• Strong computer skills including experience working with the following: Microsoft Office Suite (Word,
Excel, PowerPoint), electronic calendar and e-mail
• Ability to work independently with attention to detail and excellent follow-through while maintaining
confidentiality as required
• Demonstrated ability to access state and federal websites for coding, billing and reimbursement
• Principles and practices of customer service and telephone courtesy
• Organizational, planning, analytical and problem solving skills
• Demonstrated verbal and written communication skills
• Epic Professional Billing, Hospital Billing, or Single Billing Office experience preferred
Physical Requirements and Working Conditions
The Physical Requirements and Working Conditions in which the job is typically performed are available from the Occupational Health Department.
Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job
For immediate consideration, please apply!
- Excellent opportunity to work for a outstanding, large and growing company!
- Renown Healthcare Organization – Huge career growth potential!
- Awesome Benefits!
- Excellent salary!
- Medical Insurance
For immediate consideration, please apply!
“Best of Staffing Award”
Best of Staffing Award is the only award in the U.S that recognizes staffing agencies that have proven superior service quality based entirely on ratings provided by their clients and job candidates. Award winners make up less than 2% of all staffing agencies in North America.
“Top Performer Award”
Top Performer Award by Workforce Logic highlights high-performing staffing companies who are chosen based on a variety of criteria critical to our clients’ satisfaction, including customers serviced, cycle time, submittals per requisition, percentage of submittals hired, program compliance, fill ratio, and more.
Member American Staffing Association Since 1991