Patient Financial Services/Customer Service Representative

Job Overview

This position is responsible for providing Fairview Health Services patients an understanding of the billing and insurance processing of their healthcare services. The CSC Representative will counsel patients on financial solutions available to them either through direct payments, payment plans, or screening for qualification for assistance programs. The CSC Representative will manage both hospital and physician accounts in all systems and understand in depth the Registration, Hospital Billing, and Clinic Billing functions that are necessary to resolve accounts. They will also be well-versed in collection practices, understanding of the Attorney General Requirements, and able to liaison with bad debt vendors when needed. They will have detailed knowledge of the Functions within the Revenue Cycle and how they interact in the life of a patient account.

• Maintains the best practice routine per department guidelines:
  • Handles fair share of calls presented to CSC through automated call distribution system. Able to work independently with patients in resolving questions and concerns.
  • Timely processing and follow-up of patient requests for payment research, checking charges, insurance processing concerns.
  • Identifies when callers need to be referred to insurance specialist or escalation staff for further assistance.
  • Notifies patient and/or guarantor of co-pays/deductible/coinsurance.
  • Work independently in problem solving with patients regarding their accounts in both hospital and clinic billing situations. Counsel the patient on the complexity of the interdependency between hospital and physician billing within the patient’s continuity of care.
• Uninsured accounts reviewed and managed to include validation that uninsured discounts have been appropriately applied, and all payment sources available to the patient have been explored.
• Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices:
  • Responsible for the analysis and processing of correspondence including rejections, requests for medical records, itemized bills, clarification of detail on bill, etc. Analyze paid claims for accuracy of payments and or rejections and properly account for payment and adjustments by both payers and patients.
  • Understanding of multiple payers in both hospital and clinic services.
  • Reviews explanation of benefits for accuracy in posting and assisting patient’s in understanding their patient liability.
  • Identify problem accounts and work towards timely resolution.
  • Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.
    Coordinate both hospital and clinic information for patients.
• Manage accuracy of accounts to insure appropriate billing and compliance with patient privacy and data integrity:
  • Verifies insurance benefits to maximize reimbursement.
  • Gathers data, summarizes, and prepares reports for management and completes special projects as assigned.
  • Work independently to manage special projects as assigned.
  • Assists customers regarding billing questions and ensures appropriate resolution of problems. Explain and interpret eligibility rules and regulations or identify other resources available for financial assistance. Identify patients who may be eligible for financial exceptions. Keep updated on changes with regulatory issues.
  • Validate patient data is accurate and authorization is in place to provide information.

• Bad debt management of accounts and interactions with vendors.

  • Counsel patients throughout the collection process on solutions available to them for account resolution.
  • Problem solve with vendors and patient on reasonable resolutions.
  • Identify patients with financial need.
• Attends periodic meetings with payer representatives to discuss discrepancies and assist in developing action plan for correction.

Required

• 2 years customer service experience 
• Individual has a strong interest in learning new IS systems (PASS, Deloitte overlay system, Healthworks, etc) as well as the ability to work independently

Preferred

• Associates degree
• 2 years in healthcare customer service 
• 3 years experience in a hospital or clinic business office 

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www..fairview.org/careers/benefits/noncontract

Compensation Disclaimer

An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical.
EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Salary : $23 - $32