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Akron Children's · 13 hours ago

Patient Billing Customer Service Representative

United States

Full-time

Remote

Entry Level

1+ years exp

Akron Children's is a healthcare organization seeking a Patient Billing Customer Service Representative. The role involves assisting families and insurance companies with concerns regarding hospital and physician services, ensuring timely processing of patient registrations and insurance information, and maintaining positive relationships while providing superior customer service.

Health Care

Responsibilities

Responsible for the timely and accurate updating and processing of patient registration, and insurance information

Responsible for investigating current insurance eligibility information through web sites established by Third Party Insurance and Governmental Payers to locate accurate information needed for timely claims submission

When questioned can review patient accounts that are denied by the insurance companies

Facilitate further investigation of denied claims to determine if denial may have been appropriate. If denial is inappropriate accounts are returned to applicable team members to appeal with the insurance for reconsideration and ultimate payment

Identifies denial trends and works with administrators or managers of various Hospital Departments

Responsible to inform leadership of denial trend information and work with them towards a resolution

Meets with coding representatives to identify and resolve denial trends

Shares information regarding denial trends with Managed Care Department to resolve payment issues at the contract level

Responsible for promoting positive internal and external relationships while providing superior customer service

May performs financial screening of guarantors and assist families with the application process for HCAP/Charity

Must have an understanding of health benefits and services rendered to identify the root cause/complaint/issue

Read/interpret and provide guidance to guarantors related to payer EOBs

May be responsible for the collection of self pay accounts billed for services, including establishing payment arrangements

May be called as hospital representative for legal collection cases and may be required to testify at court hearings

Triage and escalate complaints and patient care issues trending as appropriate

Responsible for special projects that support the Revenue Cycle process

Create and maintain spreadsheets for projects as needed

Other duties as assigned

Qualification

Customer ServiceMedical TerminologyICD9/10 CPT CodingData ProcessingMicrosoft ExcelMicrosoft WordAnalytical SkillsEPIC ExperienceInterpersonal SkillsAttention to DetailCommunication Skills

Required

High school graduate or equivalent required

One (1) year experience in a physician/hospital billing setting required

Must have strong interpersonal skills as required to handle sensitive and confidential information

Must have above average communication and organizational skills to communicate verbally, prepare written communications for patients, patient families, physicians, third party payors, collection agencies, attorneys and other staff members

Prior experience in processing personal and confidential data when updating demographic and medical insurance information

Is proficient in utilizing third party and governmental web sites to locate accurate information needed for timely submissions of coverage and claim processing

Must have experience with computerized physician/hospital systems

Ability to process large amounts of data in a timely manner, executes projects, create and maintain spreadsheets

Ability to demonstrate professionalism, strong customer service and analytical skills

Highly developed attention to detail with ability to cross train to other functions as necessary

Numerical aptitude and the ability to exhibit proficient personal computer skills including, but not limited to, Microsoft Word and Excel is required

Must be results oriented and able to work independently to set priorities