The Customer Service Representative handles customer inquiries in a timely, professional manner to solicit customer satisfaction through the resolution of issue(s). Responds to inquires timely and accurately. They are responsible for triaging the call and electronically referring the account to the appropriate area for resolution. This individual validates and updates critical demographic and insurance data and forwards the revised information to the appropriate. Provides excellent customer service in not only resolving inquires, but assisting the customers navigate through the Ministry Organization and the billing process.
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
Handles all inbound customer inquiries (telephone, fax, mail and web-based patient portal) and responds to customer requests with the highest level of customer quality possible:
Communicates with physicians and their office staff, Patient Access, Medical Records/Health Information Management, Utilization Review/Case Management, Managed Care, Ancillary and Nursing staff, as required to clarify customer service inquiries.
May prepare special reports as directed by the Manager to document billing and follow-up services (e.g., Number of contacts, contact issues/reasons, number of unresolved issues, etc.).
May serve as relief support, if the work schedule or workload demands assistance to departmental personnel. May also be chosen to serve as a resource to train new employees. Cross- training in various functions is expected to assist in the smooth delivery of departmental services.
Other duties as needed and assigned by the manager.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
High school diploma or an equivalent combination of education and experience. Associate degree in accounting or business administration highly desired. Data entry skills (50-60 keystrokes per minutes). Past work experience of at least one year within a healthcare environment, performing customer service, financial counseling, and/or financial clearance is required. Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required. Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-9, CPT, HCPCS), multilingual and basic computer skills are highly desirable.
Demonstrated call center experience with the ability to utilize voice/data equipment to fulfill customer expectations is strongly preferred.
Excellent communication (verbal and writing) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers, including the ability to interpret customer requirements, recommend and take action to satisfy the customer’s needs. Accuracy, attentiveness to detail and time management skills are required.
To successfully accomplish the essential job functions of this position, the incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
Must be able to set and organize own work priorities, and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Excellent problem solving skills are essential.
This position requires the ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery.
The greatest challenge in this position is to ensure that customer service activities are performed promptly and in an accurate manner to assist in order to reduce potential financial loss to the patient and the Ministry Organization. The incumbent must have a thorough knowledge of various insurance documentation requirements, the patient accounting system, and various data entry codes to ensure proper service documentation and billing of the patient's account.
Position operates in an office environment. Work area is well-lit, temperature controlled and free from hazards. The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen. The noise level is low to moderate.
Completion of regulatory/mandatory certifications and skills validation competencies preferred.
Must possess the ability to comply with Trinity Health policies and procedures.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
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