Patient Contact Center Representative - PRN Days

Job Summary

This position is responsible for answering incoming and making outbound patient phone calls with regards to billing inquiries and patient collection activities within a high volume call center environment related to professional and facility services in an efficient, friendly, courteous, tactful, calm and helpful manner. Document and code appropriately all work performed. Pursue complete collection activity prior to referring accounts to bad debt agency. Research patient complaints and questions in a timely manner, escalating to leadership as appropriate, and keeping patient informed of progress throughout process.
 

Minimum Job Qualifications

• Licensure or other certifications: High School Diploma or GED

• Educational Requirements:

• Minimum Experience: One (1) year minimum collection, customer service or business office experience.

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements: Two (2) years of college or Business School.

• Preferred Experience:

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Solid knowledge of Revenue Cycle functions, including registration, coding/charge posting, and insurance billing and collections

• Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently

• Excellent listening and problem-solving skills with attention to details

• Excellent customer service skills and ability to remain calm and professional in stressful situations

• Excellent verbal and written communication skills

• Ability to work independently within guidelines

• Telephone proficiency

Essential Tasks and Responsibilities

• Accepts all calls via the ACD (Automated Call Delivery) lines in a manner that keeps wait times to a minimum. Identifies self by name and department, handles call in professional manner, asks if all issues resolved and if anything else may be needed prior to ending call.

• Performs collection activities on outstanding patient balance, offering payment arrangements per guidelines when patient unable to pay in full (Monthly Payment Plans; Payroll Deduction).

• Reviews accounts thoroughly, verifying balance to be correct. Performs required action to correct balances found to be in error. Refers errors to other departments for assistance only when appropriate.

• Analyzes all details of account for accuracy and resolves all insurance questions including payment, adjustments and benefits.

• Researches all patient complaints and inquiries in a timely manner, keeping patient informed of progress when other departments must be consulted.

• Escalates issues to SPRC leadership following standard work guidelines.

• Documents and uses appropriate disposition codes in system for every account, including any action taken in order to allow for trending and process improvement as well as continuity of customer service.

• Meets or exceeds required quality, productivity and collection performance standards as determined by SPRC leadership.

• Follows required collection process.

• Follows all department and NGHS guidelines, policies, and standard work.

• Provides resolution to patient calls and/or walk-ins based on established standards and procedures.

• Attends all Weekly/Monthly/Quarterly/Annual SPRC and Team Meetings (unless has an excused absence).

• Serves as a positive role model to all staff members, physicians, patients and visitors.

• Remains in good standing with all NGHS policies including those related to attendance, positive attitude and staff development.

• Works with patient/guarantor to find insurance, third-party sponsorship, settlement, or to begin charity process. Responsible for forwarding information found to appropriate Specialist for follow-up.

• Follows scripting guidelines outlined by Supervisor/Manager when interacting with patients to maintain high quality of service. Listens and thinks critically to make sound judgments on patient accounts.

• Maintains an understanding of health insurance and EOB's, collection processes and techniques, and NGHS Financial Assistance Programs.

• Adapts to frequently changing atmosphere including organizational and technological changes.

• Performs other duties as assigned, including but not limited to bankruptcies, researches estates, and follows up on defaulted internal and external payment plans.

• Promotes and contributes positively to the teamwork of the department by assisting coworkers, contributing ideas and problem-solving with co-workers and helps identify trends affecting patient billing and customer satisfaction.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Occasionally 0-30% of time

• Kneeling/Stooping/Bending: Occasionally 0-30%

• Standing/Walking: Occasionally 0-30%

• Pushing/Pulling: Occasionally 0-30%

• Intensity of Work: Frequently 31-65%

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding