Pat Financial Svc Rep I

Responsible for answering a high volume of inbound daily telephone calls within Patient Financial Services department, a cross-functional department supporting all areas of Children's Hospital and Children's Specialty Group (MCW) revenue cycle. As the front line of CHW and MCW/CSG's revenue cycle, must provide exemplary service to our patients and families showing empathy and compassion while still working to meet the goals of resolving account balances. Troubleshoots and problem solves patient family billing, payer, payment posting or system issues for all areas of the organization.

Essential Functions:

• Works as part of a cross-functional team that must maintain knowledge of all hospital billing, physician billing, coding, medical records, and financial clearance functions across multiple service areas.

• Acts as a patient resource for navigating through the various departments of our health system.

• Works in a fast-paced call center environment, promptly and professionally answering inbound telephone calls, meeting department service standards and expectations.

• Negotiates payment plan arrangement and screens for financial assistance needs.

• Responds to patient’s questions in a timely, professional manner

• Multi-tasks by working accounts in work queues to resolve self-pay balance issues while answering inbound calls.

• Utilizes patient billing software, which includes adding appropriate documentation of steps taken to obtain payment, respond to inquiries or resolve accounts

• Educates and supports parents, families, and representatives with questions regarding CHW account balances.

• Educates families on insurance and revenue cycle processes.

• Determines when rebilling is appropriate and takes necessary steps in billing system to complete.

Legacy Essential Functions:

• Reviews in-coming correspondence and respond accordingly. Updates billing information

• Reviews and updates return mail with new addresses

• Utilizes Forward Health eligibility website to search for coverage for uninsured patients and takes necessary steps in billing system to complete eligibility check

• Investigates and resolves straight forward credit balances. Determines appropriate next steps; transferring funds, requesting patient refund

• Collaborates with Financial Counseling, Social Services, Patient Relations, Account Resolution Reps or other department members to resolve patient concerns, and patient balances

• Works within the Medical College of WI service area in billing system to resolve shared services account balances

• Escalates situations to leadership when appropriate for service recovery and timely resolution

Education:

• High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED) Required

Experience:

• 1+ years related experience in insurance, collections, or customer service experience preferably in a healthcare setting. Required

Knowledge, Skills and Abilities:

• Knowledge of claims processing and computerized systems desirable.

• Interpersonal skills necessary to efficiently respond to questions from patients and families regarding hospital financial policies, outside agencies’ programs and physician offices to help resolve patient financial issues.

• Ability to hold composure and poise in escalated situations.

• Strong multi-tasking, organizational and time management skills.

• Ability to verbally communicate effectively in a professional manner to families, physicians and outside agencies.

• Ability to work as part of a team, demonstrating collaboration and flexibility.

• Must have knowledge of all revenue cycle operations and processes.

• Must be able to read and interpret insurance explanation of benefits to accurately process work and resolve problems

Required for All Jobs:

• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.

• Employment is at-will. This document does not create an employment contract, implied or otherwise.