What are the responsibilities and job description for the Customer Service Associate position at WMC Health Network?
The Customer Service Associate is responsible for managing the day-to-day processes of the call center. This position documents and resolves patient concerns and inquiries for the hospital and associated physician bills. In addition, this position will work closely with the Directors of Patient Relations on the resolution of complex patient complaints involving quality of care issues.
Responsibilities:
• Follows up and resolves outstanding issues related to insurance questions/payments when requested.
• Coordinates with other departments when necessary in order to expedite the resolution of the patient's issues in a timely manner.
• Notifies management of any escalating issues and potential trends in types of calls or customer complaints.
• Ensures all customer inquiries/complaints related to patient accounts are resolved in a timely manner.
• Arranges for Financial Assistance-Charity Care according to Federal and NYS regulations as necessary.
• Operates multiple patient information systems to resolve potentially complex accounts.
• Manages estate checks and deceased patient account resolution.
• Addresses inquiries from multiple sources including attorneys, insurance companies, patients and BSHSI Centers of Excellence.
• Retrieves and interprets payment documents from insurance companies and other sources.
• Ensures the appropriate revenue cycle flow is followed in order to optimize customer service and reduce patient liabilities.
• Ensures patients are aware of all financial assistance programs and coordinates with the appropriate vendor to make sure the patient receives the maximum level of assistance.
• Coordinates with the Billing Center of Excellence for situations that may require re-billing, additional reviews or edits to a claim.
• Offers patients monthly payment solutions when needed and facilitates the setup of Charity's self-pay vendor.
• Follows all HIPAA (Health Insurance Portability and Accountability Act) rules and regulations.
• Performs other duties as assigned.
Qualifications/Requirements:
Experience: 3 to 5 years of experience in a hospital customer service, call center, billing or follow-up preferred.
Education: High school diploma or equivalent preferred or meets experience requirements listed.
Licenses / Certifications: N/A
Other: N/A
Special Requirements: N/A
Responsibilities:
• Follows up and resolves outstanding issues related to insurance questions/payments when requested.
• Coordinates with other departments when necessary in order to expedite the resolution of the patient's issues in a timely manner.
• Notifies management of any escalating issues and potential trends in types of calls or customer complaints.
• Ensures all customer inquiries/complaints related to patient accounts are resolved in a timely manner.
• Arranges for Financial Assistance-Charity Care according to Federal and NYS regulations as necessary.
• Operates multiple patient information systems to resolve potentially complex accounts.
• Manages estate checks and deceased patient account resolution.
• Addresses inquiries from multiple sources including attorneys, insurance companies, patients and BSHSI Centers of Excellence.
• Retrieves and interprets payment documents from insurance companies and other sources.
• Ensures the appropriate revenue cycle flow is followed in order to optimize customer service and reduce patient liabilities.
• Ensures patients are aware of all financial assistance programs and coordinates with the appropriate vendor to make sure the patient receives the maximum level of assistance.
• Coordinates with the Billing Center of Excellence for situations that may require re-billing, additional reviews or edits to a claim.
• Offers patients monthly payment solutions when needed and facilitates the setup of Charity's self-pay vendor.
• Follows all HIPAA (Health Insurance Portability and Accountability Act) rules and regulations.
• Performs other duties as assigned.
Qualifications/Requirements:
Experience: 3 to 5 years of experience in a hospital customer service, call center, billing or follow-up preferred.
Education: High school diploma or equivalent preferred or meets experience requirements listed.
Licenses / Certifications: N/A
Other: N/A
Special Requirements: N/A
Salary : $18 - $22