Customer Care Specialist - MedStar Unified Revenue Cycle Organization

MedStar Health is seeking highly qualified, experienced, and customer-focused professionals to join our Customer Service Call Center team as a Customer Care Specialist.  Medical billing experience and knowledge are essential for this position. We are looking for a candidate with a demonstrated background in medical billing, exceptional customer service skills, and the ability to confidently and professionally handle customer inquiries.

Schedule: Monday–Friday, 9:30 AM–6:00 PM

As a Customer Care Specialist, you will serve as the primary post-service contact for the MedStar Health Customer Service Call Center. Identifies the nature of inquiries, discerns potential implications for internal & external entities. Using both MedStar billing systems (IDX and SMS), internal/external resources, applications, and processes to resolve cases. Provides a single point of contact from origin through final resolution for all patient billing, coding, service, and insurance concerns. Uses appropriate guidelines and discretionary authority to make decisions concerning proper resolution of documented service recovery cases. Special emphasis on educating the patient, building rapport and service recovery is all aimed at enhancing the patient experience.

Primary Duties:

• Advocates on the patients’ behalf to achieve best results, gain patients’ trust and build rapport. Interacts regularly with patients, MedStar Health staff from all areas, collection agency liaisons, website vendors, outside labs, etc. Uses established guidelines to make independent decisions concerning specific patient issues in need of resolution. Answers and resolves patient/guarantor inquiries daily, via telephone, mail, fax, and email. Meets the departmental weekly standards for calls taken, mail handled, and other forms of customer contacts resolved. Meets specific standard turnaround times as they apply to number of calls answered, speed of answer, hold time, personal call abandonment rate, etc. Meets expected turnaround times for resolving interdepartmental issues, cases deemed “urgent” or in need of special handling, and response time to customers. 

• Serves as the single point of contact for the patient. Liaises, advocates, research, and analyzes documents, records, prior precedent-setting cases, discusses and reviews with both internal and external sources, etc., until final adjudication or resolution is achieved. Uses MedStar Health's billing systems and the MedStar Payment Portal to help customers with their billing and payment concerns. Annotates invoice or account after each inquiry to ensure proper documentation of inquiries and resolutions. Ensures correct upload of documents for proper retention. Knowledge of the functions of all MedStar Health’s non-telephony methods of customer contact.

• Applies knowledge of MedStar Health’s Managed Care contracts and the associated rules for claim processing to achieve proper reimbursement and customer satisfaction. Participates in training sessions, workshops offered, staff meetings, work events, task force, committees, and community outreach efforts. Communicates to leadership any system or procedural problems/inconsistencies to prevent problem recurrence and/or to improve existing processes. Corrects invoices and accounts in both systems that have erroneous registration and/or insurance information and ensures all associated claims have the correct financial classification for timely processing/reprocessing.

• Exemplifies Spirit Values in all activities in areas of service, resource utilization, high quality outcomes and effective communication. Interviews patients in need of referral or recommendation to appropriate support and/or charity care programs. Proposes budget/payment plans to customers as the situation warrants and in accordance with MURCO policies and Maryland State regulations. Keeps abreast of regulatory and specific changes as they relate to HCFA 1500 and UB04 billing requirements and payer-specific follow-up. Maintains departmental QA standards within established error rate. Meets the established standards for abandoned calls, duration of calls and the amount of time that patient is held in queue, etc.

Qualifications:

• High School Diploma or GED

• 2 years’ experience in patient accounting or related healthcare field.

• 1 year of customer service experience.

• Associate or bachelor's degree preferred.