Escalation Specialist
At Houston Methodist, the Escalation Specialist position is responsible for acting as a liaison between the patient and the hospital, the Physician Organization (PO) and / or payers for billing related matters. The Escalation Specialist's primary role is to facilitate resolution to elevated issues that may require in-depth research and analysis to resolve. This position also provides feedback to other customer service team members and management to create educational opportunities for improvement.
Houston Methodist Experience Expectations
- Provide personalized care and service by consistently demonstrating our I CARE values :
- Integrity : We are honest and ethical in all we say and do.
- Compassion : We embrace the whole person including emotional, ethical, physical, and spiritual needs.
- Accountability : We hold ourselves accountable for all our actions.
- Respect : We treat every individual as a person of worth, dignity, and value.
- Excellence : We strive to be the best at what we do and a model for others to emulate.
- Practices the Caring and Serving Model
- Delivers personalized service using HM Service Standards
- Provides for exceptional patient / customer experiences by following our Standards of Practice of always using Positive Language (Aidet, Managing Up, Key Words)
- Intentionally collaborates with other healthcare professionals involved in patients / customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience
- Involves patients (customers) in shift / handoff reports by enabling their participation in their plan of care as applicable to the given job
- Actively supports the organization's vision, fulfills the mission and abides by the I CARE values
Responsibilities
Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal department and organizational results.Follows the standard talking points outlined in department protocols when interacting with patients to ensure high quality and consistent service.Works collaboratively with all necessary internal and external stakeholders to ensure resolution of escalated patient issues and concerns.Qualifications
Education : High School diploma or equivalent education (examples include : GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)Work Experience : Five years of previous call center and hospital revenue cycle experienceLicense / Certification
Licenses and Certifications - Required : N / AKsa / Supplemental Data
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluationsSufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or securityAbility to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principlesWorking knowledge of the patient billing cycle for both hospital and professional billingExcellent customer service and professional communication skills with the ability to remain calm in stressful situationsKnowledge of medical terminology and applicabilityExcellent spelling / grammar skillsManaged care knowledge with the ability to differentiate between insurance plans such as PPO, POS, HMO, etc.Ability to multi-task and flexibility to meet the requirements of the department and the organizationAbility to problem solve in the moment and provide recommendations in alignment with valuesProficient computer skills and ability to learn and navigate multiple software programsStrong training, leadership and mentoring skillsAbility to analyze data elements and identify trendsBilingual skills preferredCompany Profile
Houston Methodist (HM) is one of the nation's leading health systems and academic medical centers. HM consists of eight hospitals : Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston metropolitan area. HM also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, HM employs over 25,000 employees. Houston Methodist is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide the best patient care and service in a spiritual environment.
In 2019 Houston Methodist and its physicians treat more than 6,333 international patients from more than 76 countries. Houston Methodist Global Health Care Services' consulting and education divisions also provide advisory services and training and development to health care organizations around the world.