Customer Service Associate (Hybrid) full time, days

Customer Service Specialist

Provides outstanding customer service in assisting patients and their families regarding payments, insurance coverage, requests for information or assistance in resolving questions or complaints concerning medical billing.

Answer incoming calls; respond to inquiries or direct caller to appropriate staff for assistance.

Manages all self-pay accounts to final resolution.

Provides outreach to patients to gather information pertaining to payments, billing, collections and financial assistance.

Verify timely filing limits and requests insurance claim as appropriate.

Update reconciliation form at end of the day.

Ensure that the safe and its contents are secure at end of day.

Assists patients by assessing balances and identify best financial option; internal payment plan, financial assistance, or HELP Financial. Present options to patient. Setting up payment arrangements as necessary.

Accurately completes payment posting and balancing of accounts.

Completes pre-screening for financial assistance applications. Reviewing applications for accuracy and completeness.

Coordinates on-site Medicaid vendor to assist in the appropriate completion of Medicaid applications.

Perform Cerner, Affinity and eClinicalWorks (Medical Group & BHS) account maintenance to resolve all patient billing questions, payments or denials.

Accurately completes patient demographics, insurance coverages and payment information.

Manages and responsible for the billing system worklist.

Responsible for patient accounts by using work queues to ensure balances are accurate before referring to third-party collection agency.

Manage patient credits. All refunds to the appropriate guarantor completed within 60 days.

Responsible for the past due work queue to determine if the collection calls are complete.

Ensure accuracy and approve account for placement with an outside collection agency according to department protocol.

Perform necessary write-off adjustments of patient balances and apply non-covered, self-pay, bankruptcy and deceased adjustments in accordance with department policy.

Log all activities ensuring account comments clarify actions taken and to record for quality control statistics.

Update address information from statement vendor as needed.

Effectively uses business office equipment or vendors including managing accounts with HELP Financial to ensure patients are abiding by their contract obligations.

Investigating accounts flagged as deceased or bankruptcy filing by reaching out to the appropriate probate and bankruptcy courts. Apply correct adjustment in the billing systems if required.

Interpretive services for English as second language patients.

Skip tracing for undeliverable mail returned from the post office.

Balancing cash drawer.

Provide excellent customer service to patients and family members by communicating in a manner consistent with positive patient relations.

Demonstrating a welcoming environment by smiling when greeting all customers.

Providing helpful assistance in anticipating and responding to the needs of all patients and family members.

Collaborating with customers in planning and decision making to result in optimal solutions.

Remaining calm under pressure and deal effectively with difficult situations and customers.

Independently recognize, interpret, and evaluate situations and their level of urgency.

Other duties as assigned.

Completes projects as assigned by leadership.

Reviews virtual credit card payments and processes them through the appropriate system for payment.

Patient Financial Advocate

Conduct financial screening of insured, underinsured and uninsured patients.

Identify the correct payer source for the visit and perform eligibility verification to confirm coverage.

Screen uninsured patients for Medicaid and refer patient to on site Medicaid eligibility vendor if it appears the patient may qualify.

If the uninsured patient is not eligible for Medicaid and is unable to make payment arrangements within specified guidelines, screen the patient for financial assistance, which includes providing the appropriate paperwork.

Determine if there are any other payment resources available to the patient and make appropriate referrals.

Obtain accurate estimate information for hospital and / or physician services.

Builds working relationships with internal departments and physician offices to identify patient costs and potential assistance eligibility.

Requests an estimate for services from the appropriate department or physician office.

Verifies benefits and determine coinsurance and deductible amounts by accessing the appropriate websites.

Creates and sends a letter to the patient identifying the charges and the patient responsibility.

Notes all information in the billing systems.

Determine eligibility for Financial Assistance

Accepts referrals from Medicaid eligibility vendor that are ineligible for Medicaid but may be eligible for another type of assistance available.

Screens patients either in person or over the phone to determine whether or not they may be eligible for financial assistance.

Analyze and process, within the parameters of the Financial Assistance Policy any applications meeting or outside the Financial Assistance Policy sliding scale.

Presents any application that is outside the PFS staff member's approval level to leadership for review and authorization to write off qualifying balances.

Prepares and mails a letter of Approval / Denial notifying the patient of his or her eligibility.

Documents the activity and status of Application in the PFS billing systems and related excel spreadsheet.

Saves scanned application and related documents in the appropriate electronic folder.

Preservice review of accounts to determine patient payment obligations.

Receives and reviews account referrals from physician offices, registration staff and any other sources.

Educates the patient on his or her responsibility for upcoming services.

Determines and discusses alternative payment arrangements for the service.

Pulls suppressed statement report from statement vendor and fixes an errors that are identified.

Follows process to generate patient statements out of eCW weekly and corrects any errors that may occur.

Thoroughly reviews claims in eCW and generates collections calls in eCW along with sending out payment plan default letters.

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy