Patient Services Resolution Representative

ESSENTIAL JOB FUNCTIONS:

• Provide excellent Customer Service to our patients, you are the face of USACS
• Manage large amounts of inbound calls from patients, patient representatives, and insurance companies, in a timely manner
• Identify the customers’ needs, clarify information, and research every issue. Resolves patient and customer billing issues, complaints and concerns by correctly answering questions; determining and recommending how outstanding patient accounts should be further processed, all while the customer is on the phone and within time limits.
• Help to identify trends and takes action to help prevent negative impact to the patient or USACS
• Review accounts in detail to obtain accurate information and follow any applicable policies including, but not limited to standard work, standard operating procedures, and any other potential matrix/resource.
• Research/Review Explanation of Benefits that reflect payment or denial of patient medical claims. Familiarity with negotiated contracts and applicable fee schedules.
• Documents and categorizes customer issues for further analysis
• Liaison with collections company to ensure proper balances, payments or adjustments are communicated
• Evaluate patient financial status and establishes payment plans according to customer needs
• Maintains working knowledge of the current state and federal guidelines, and HIPAA regulations stipulated by the government and USACS
• Adheres to USACS Code of Conduct, House Rules, Missions and Values
• Serves as an essential communication link for the USACS clinicians and billing company
• Multi-task in between calls and work patient correspondence with regards to updating insurance information, attorney requests, address corrections, bankruptcies, returned mail, etc.
• Adhere to department work schedule and department attendance policy to insure adequate coverage of call center hours

KNOWLEDGE, SKILLS AND ABILITIES:

• Strong phone contact handling skills and active listening, with a great emphasis on being able to communicate with patients/customers, co-workers, and management
• Customer orientation and ability to adapt/respond to different types of characters, while maintaining professionalism, composure, and empathy
• Knowledge of and skill in using personal computers in a Windows environment; Excel, Word, and Outlook
• Knowledge of medical insurance and its terminology
• General knowledge of basic ICD-10 and CPT coding is helpful
• Excellent communication and presentation skills
• Ability to perform basic mathematical calculations such as adding, subtracting, multiplying, and dividing
• Ability to multi-task, prioritize, and manage time effectively
• Ability to take the initiative and work independently and within a team; support will be available
• Ability to recognize trends and pay close attention to detail – problem solving and problem analysis
• The call center environment can be stressful, it is important to have the ability to be relaxed and easy going in the face of adversity
• Must be able to work in a fast paced, ever-changing environment
• Displays an eagerness and capacity to learn when faced with new situations and problems
• Ability to accept constructive feedback and resilient
• Ability to take the initiative and work independently and within a team; support will be available
• Ability to recognize trends and pay close attention to detail – problem solving and problem analysis

EDUCATION AND EXPERIENCE:

• High school diploma or equivalent.
• Experience in call centers, customer service, medical insurance, or billing is helpful, but not required.

PHYSICAL DEMANDS:

• While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds.
• Required to have close visual acuity to perform the job

Hourly Rate: $14.53-$26.88

The rate offered for this position will be in the range of $18.25/hour