Hours for this position are 9 am - 5:30 pm, but may be adjusted to meet the needs of the department.
Handles inbound and outbound customer calls to resolve inquires in a timely and accurate manner; in a patient focused manner that enhances the experience of patients and their families.
- Appropriately research and document all information from phone conversations and applies the appropriate transactions as appropriate to patient accounts;
- Works with internal and external resources as appropriate to support requests needed;
- Process payments by phone via electronic check, credit card, hard copy, payment database or any other approved means.
- Understand, explain, execute and help determine eligibility for hospital financial assistance programs.
- Assist patients with payment plan arrangements including collecting initial down payment as part of the process by following established departmental policy.
- Identify patient or customer needs, clarify information, research and analyze issues, and provide solutions and/or appropriate alternatives.
- Maintains patient and physician confidentiality and professionalism in accordance with departmental and HIPPA guidelines at all times.
- Consistently communicates issues and helps to review and implement people, process and technology improvements as appropriate.
- Performs various duties such as: Researching accounts, processing adjustments, refunds, and responding to patient correspondence that maximizes revenue collection.
- Process all necessary documentation to process system reports and work lists and correct patient accounts in accordance with established time frames to ensure accounts accuracy, increase revenue and promote positive public relations.
- Coordinates with agencies and other departmental vendors as appropriate to resolve patient accounts.
- Monitors self-pay accounts and reviews accounts according to department policies to refer to the outside collection agencies.
- Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims.
- Assists in the analysis of claims resolution and provides feedback to management to put in place solutions and process improvements.
- Assists in the development of new procedures/process with a focus on improvement in quality and quantity of work performed.
- Assists in the establishment of performance goals, monitors compliance.
- Enters charges and payments in accord with established guidelines, policies and procedures
- Performs other duties as assigned
Experience & Knowledge:
- Minimum 2 year medical billing / Accounting experience required.
- 1 +year customer service phone experience working with multiple screens required.
- Minimum 1 year direct Revenue Cycle Customer Service Department experience preferred.
- Exceptional written and verbal communication skills
- Advanced knowledge of medical billing and claims terminology and workflow processing.
- Consistently demonstrates advanced analytical and problem solving skills.
- Exceptional client service, communication, and relationship building skills required.
- Advanced knowledge of claim submission (UB04/HCFA 1500) and third party payers required.
- Self-motivated, works independently and consistently demonstrates the ability to perform with little to no supervision in a fast-paced environment.
Special Skills & Equipment Knowledge:
- Self-motivated, works independently and consistently demonstrates the ability to perform with little to no supervision in a fast-paced environment. Demonstrated proficiency with PCs, with HIS systems as well as Microsoft software Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.) required.
- Experience with medical billing software required.
Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.
Location/Region: Cleveland, OH (US - 44101)