Pt Serv Rep (BHS)

Reports to the Director or Manager. Under general supervision, responds to routine inquiries and provides customer service to any/all individuals connected to department. Receives telephone calls, records caller information, answers questions, research problems and resolves issues. When applicable, forwards caller to appropriate person(s) to handle specific situation. Serves as a resource person for departmental needs and related questions. Provides personal secretarial services and administrative assistance in accordance with established policies and procedures. Duties may include typing correspondence, composing letters and memos, setting up and maintaining files and record keeping systems, greeting and directing visitors, preparing reports, taking and transcribing dictation and performing other clerical duties. The position requires using discretion and independent judgment on general administrative functions, departmental services and special projects.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Responds to routine inquiries and provides customer service to providers, payers or brokers and insured members, and office staff by:

• Receiving telephone calls from members and providing caller with reasonable assistance with the utmost regard for customer service and guest relations.
• Answering insurance and/or claim/provider questions.
• Researching claim problems or questions, discussing reprocessing of claim(s), date of resolution and forwarding to payer, as appropriate.
• Placing follow-up calls to providers to advise claim resolution status.
• Forwarding caller to appropriate person to handle specific situations, if required.
• Answering provider status calls.
• Serving as a CHA resource person for insurance related questions.
• Greeting Visitors and directing them as necessary.
• Opening, sorting and distributing mail, and responding to routine requests for information.

Provides secretarial services and administrative assistance to Executive Directors and Directors that report to the Chief Growth & Strategy officer by:

• Preparing a variety of material (from draft or dictation) and composing routine correspondence.
• Working on and coordinating semi-complex special projects.
• Establishing and maintaining record-keeping and filing systems.
• Gathering data from department records, calculating, compiling and completing routine statistical reports and summaries and preparing budget variance reports.
• Contacting various associates to obtain information or relay information regarding meetings or to resolve payroll, purchasing and computer-related problems.
• Assisting with training and general orientation for new associates.
• Assist with scheduling travel as appropriate.

Provides assistance for CHA:

• Collecting information for, organizing and distributing packets for the CHA board meetings.
• Collect payments (paper and electronically) and complete monthly financials for CHA, maintain database of what is due and what is collected.
• Provider data to Beacon finance for completion of CHA monthly, quarterly, and or yearly financials.
• Deposit all payments into CHA accounts as appropriate.
• Coordination of all board and committee meetings.
• Complete CHA board and committee minutes.
• Communication with board members and medical directors for meetings as appropriate.

Contributes to the overall effectiveness and efficiency of the department by:

• Completing other job-related duties and projects as assigned.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The above level of knowledge, skills and abilities are normally acquired through the successful completion of a high school diploma. Associate's Degree in Business or related field from an accredited college or university preferred. Requires a minimum of two years of customer service experience in a physician office requiring the development of the above skills. Preference will be given to individuals with a customer service background in a healthcare or medical services field.

Knowledge & Skills

• Requires basic knowledge of managed care delivery systems to respond to routine inquiries.
• Requires working knowledge of medical terminology and ICD-9 and CPT-4 reference material.
• Demonstrates proficiency in basic computer skills (i.e. data entry, word processing, spreadsheets and database applications).
• Demonstrates high level of interpersonal skills required to interact and deal effectively with various people including providers, payers or brokers and insured members.
• Demonstrates strong verbal and written communication skills in order to communicate effectively with various internal and external contacts.
• Demonstrates knowledge of and a commitment to Beacon Health System's mission and values; and the organization's goal of providing exceptional patient experiences by following the Performance Essentials.
• Requires the physical ability and stamina to perform the essential functions of the position.

Working Conditions

• Works in an office environment.

Physical Demands

• Requires the physical ability and stamina to perform the essential functions of the position.