Customer Service Billing Specialist (REMOTE)

Overview:

The Customer Service Billing Specialist works as part of central Revenue Cycle team to offer both internal and external customer service in relation to patient accounts. The Customer Service Billing Specialist is responsible for overseeing the billing process for our patients and the timely resolution of all inquiries routed to the billing phone queue, MyChart InBasket messaging, and CUC's internal email groups. They are also responsible for collecting and posting of patient payments and finding financial solutions for patients needing payment assistance.

Essential Duties:

• Ensure all calls routed to the billing phone queue and all billing inquires sent via MyChart InBasket are promptly answered and resolved in accordance with CUC approved billing policies and procedures.
• Provide customer service support to patients by educating them on insurance policies, billing procedures, member benefits and financial responsibility.
• Serve as a point of contact for internal inquiries related to Revenue Cycle via CommUnityCare's internal billing email group.
• Collaborate with team members across all departments to resolve billing inconsistencies related to, but not limited to denials, coding, credentialing, and system configuration.
• Inform and educate patients on various program benefits CommUnityCare offers and what services they cover, then initiate contact with a financial screener.
• Verify patient insurance coverage, grant funding, and sliding fee scale programs and update records accordingly and ensure claims submitted to correct payer.
• Process and post patient payments (credit card, checks, and money orders) in an accurate and timely manner in accordance with department policies and procedures.
• Reconcile bank deposit logs to ensure all payments are accounted for and properly posted and documented in various financial logs.
• Identify overpayments and process refunds in a timely manner.
• Review of patient credit work queues to ensure accurate posting and distribute undistributed credits to the correct charge.
• Prepare, review and send patient statements.
• Evaluate patient's financial status and establish budget payment plans.
• Follow-up and report status of delinquent payments on accounts on a payment plan.
• Collect, review, and document referrals and pre-authorizations to ensure accurate reimbursement.
• Process patient billing record request initiate by the patient.
• Collaborate with third-party vendors and utilize multiple software systems to aid in resolving billing discrepancies.
• Resolves patient billing complaints utilizing de-escalation and conflict resolution techniques.
• Review accounts for possible mistakes and prepare information for adjustments and/or write-offs.
• Assist in onboarding and training of new hires.
• Ensure highest level of sincerity, integrity and honesty while dealing with customers.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs any other duties as needed to drive the vision, fulfill the mission, and abide by the values of this organization.

Knowledge/Skills/Abilities:

• Knowledge of medical billing/collection practices.
• Knowledge of Medicaid and Commercial payers.
• Knowledge of medical computer software, including Electronic Medical Records (EMR).
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a computer, computer programs, and basic office equipment including a multi-line telephone system.
• Ability to read, understand and comprehend the CPT, ICD 10 and HCPCS manual.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, and management.
• Must be well organized and detail oriented.
• Bilingual in oral and written Spanish and English required
• Cooperative work attitude towards co-employees, management, patients, visitors and physicians.
• Ability to promote favorable company image with physicians, patients, insurance companies, and the general public.
• Ability to make decisions and solve problems.
• Ability to follow instructions and to meet deadlines.
• Requires excellent communication skills with attention to detail and timeliness.
• Maintain regular and predictable attendance.
• Promptly identify issues and develop action plans for resolution with supervisor.
• Uses organizational resources appropriately and avoids wasteful practices.

MINIMUM EDUCATION:
- High School Diploma or GED

MINIMUM EXPERIENCE:
- 2 years in a  billing role
- Bilingual in oral and written Spanish and English required