Patient Financial Services Representative

Koya Medical, a privately held company founded in 2018, is a transformative healthcare company developing breakthrough treatments for venous diseases and lymphedema to enable joint contractions, patient mobility, and personalized care that is unavailable with traditional compression therapy. Koya is always looking for curious and passionate individuals who want to join a fast-paced team for a career in transforming venous and lymphatic care through innovative people-centric technologies that improve lives and empower self-care. Koya values integrity, humility, hard-work, camaraderie, and fun. We offer a base bonus compensation package, and a competitive benefits program.

Job Summary

We are looking for resourceful, energetic, and compassionate teammates to fill a critical and integral role within the organization and the patient journey. This candidate will engage extensively with patients via telephone, email, fax, and text/chat. The Patient Financial Services Representative is confident at troubleshooting and will investigate if they do not have enough information to resolve customer complaints and inquiries. Their goal is to provide excellent service and to demonstrate our commitment to customer success with top tier support.

This position will report to the Senior Manager, Customer Care. The role is full-time, exempt and will work in a hybrid role in our Dallas, TX location.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Provide insurance and billing related support to customers by phone, text, or email (approximately 80%)
• Complete outgoing Medicare Reinspection calls (approximately 10%)
• Complete Patient Financial Outreach in the case of coverage denial (approximately 10%)
• Educate patients regarding flexible payment options when appropriate
• Take incoming calls from patients to assist with resolving their insurance or billing inquiries and balance payments.
• Follow – and continuously improve – standard procedures
• Build a knowledge base of troubleshooting resolutions
• Work on special projects as needed
• Identify process improvement opportunities and participate in improvement plans
• Maintain working knowledge of Medicare, Medicaid, and commercial insurance plans, including coverage requirements, billing processes, and reimbursement guidelines.

Minimum Qualifications

Education, Experience and Training

• 5 years of experience in medical billing, including both inbound and outbound calling
• 2 years of Customer Service experience
• Associates degree or equivalent

Knowledge, Skills and Abilities

• Demonstrated ability to perform the essential functions as outlined above
• Knowledge and interpretation of insurance, and medical billing processes and documents – including commercial, Medicare, and Medicaid.
• Ability to clearly and effectively communicate in both written and verbal form
• Self-driven with the ability to work independently and accurately
• Excellent communication and customer service skills, including de-escalation tactics.
• Computer proficiencies, including Microsoft office and Salesforce preferred
• Perform common customer service transactions, interactions, and activities. Log all customer/patient interactions.
• Ensure compliance with all departmental policies and procedures; adhere to all required health care regulations, security, compliance, and HIPAA policies.
• Ability to handle difficult patient interactions in a professional and timely manner; facilitate the resolution of customer issues by following the escalation process when necessary.

Core Competencies

Organization Skills, Continuous Improvement, Problem Solving, Personal Effectiveness, Decision Making, Foster Teamwork, Ethical Conduct, Detail Oriented. Personal Initiative, Time Management, Active Listener

Tools and Technology

NikoHealth, ConnectPlus, Microsoft Office Suite, Adobe, Salesforce CRM

Physical Functions and Work Environment

The physical functions described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any Koya manager authorized to provide instruction or assign work. Duties, responsibilities, and activities may change at any time with or without notice.

All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

Koya Medical, Inc. is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.