Customer Service Specialist

San Rafael, CA, United States

**Customer Service Specialist** Job Number **11040 - DJTBD** Hours Per Two-Week Period **80** Shift Hours **8 Hour Shift** **WHAT WE OFFER:** Marin Health offers a generous suite of employee benefits, which includes a comprehensive and rich health benefits program (medical, dental, vision and prescription plans) at zero cost to you and your family. Our robust Wellness @ Work program (e.g. onsite health & fitness classes, discounts, etc) also promotes a healthier lifestyle for employees and to support you on your Healthy Healer journey. Other benefits include, but are not limited to, a 403(b) contribution plan and company-funded retirement plan, life insurance, vacation, holiday and sick leave, which you will start accruing immediately. Our benefits are highly competitive and considered to be one of the best in the Bay Area! Find your healing place at Marin Health. External hires must pass a background check and medical screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with federal, state and local laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classifications protected by federal, state & local laws. ****JOB SUMMARY:****

The Customer Service Specialist is a liaison between the community and the hospital. They must be able to work tactfully and efficiently with all patients, the public, and other hospital employees. In the interest of outstanding customer service, they must be highly trained in business office operations, knowledge of all third party payor arrangement, self-pay and charity patients. Possess advanced knowledge an experience of all Patient Accounting functions.

The Customer Service Specialist serves as the initial point of contact with the business office for most incoming phone calls and mail. The Customer Service Specialist will monitor all calls initially and if unable to handle the call, they will refer it to the appropriate follow up representative.

The Customer Service Department will be responsible for the overall duties listed, but individual Specialists may be assigned segregated duties required to assure overall work flows are met.

**JOB SPECIFICATIONS:**

**EDUCATION**

High school diploma or equivalent preferred. Candidate must show willingness to participate in on-the-job training, possibly including outside education.

**EXPERIENCE**

Minimum of 2 years experience in a Patient Accounting/Business Office setting. Must have previous experience working with Business Office customers.

**PREREQUISITE SKILLS**

Must possess strong customer service skills, ability to work tactfully with patients, families and all other hospital staff. Able to handle a high level of calls and provide effective answers and resolutions in an expeditious and effective manner. Must be detailed oriented and capable of recording information correctly and timely. Bilingual preferred.

****LICENSE/REGISTRATION/CERTIFICATION:****

**N/A**

**PRIMARY CUSTOMER SERVED** (Age Specific Criteria)**:**

This position is not a patient care position, and as such, this section does not apply.

**PATIENT PRIVACY** (HIPAA compliance)**:**

This position has access to protected health information. The protected health information this position has access is demographic information, date of service information, insurance/billing information and medical record summary information. This position requires this patient health information in order to perform the functions outlined as part of this position description.

**DUTIES AND RESPONSIBILITIES:**

**ESSENTIAL (not modifiable)**

These tasks apply to the Customer Service unit as a whole and may be divided amongst each of the Customer Service Specialists.

- Primary role for all Customer Service Specialists is the timely and accurate handling of patient calls regarding changes, errors and questions.

- Accounts requiring additional assistance with insurance matters are to be referred to the appropriate patient account rep.

- Provide patients or insurance companies with requested account documentation such as a bill summary, itemized statement or other records that are available on the Hospital Information System (HIS).

- Work closely with patients who have pending Medi Cal, CMSP or other coverage to assure timely payments. Refers accounts to outside vendor as required to assure timely eligibility.

- Assists patients with other payment or account handling resources (e.g. Charity, prompt pay discounts, etc.) in an effort to facilitate a timely resolution.

- Receives Charity care applications and reviews for proper completion. Charity Applications with missing information are sent a notice advising of need for information.

- Track Charity accounts that are pending information. If patient fails to follow through, document account and change to self pay.

- Log all approved and denied Charity Care applications, assure all paperwork is attached and file.

- Open all mail and distribute as required. Work all returned mail within 3 working days and update accounts as necessary.

- Make all insurance updates and corrections within the Paragon system, request a re-bill, document the account and change the carrier within 72 hours of receipt.

- Receive and process all subpoenas and requests for itemized bills for attorneys, patients and other parties with authorization.

- Work self-pay accounts as they call or are assigned. Part of this duty may include the review and working of the A4 listing prior to bad debt referral.

- Work with patients to set up payment plans and provide assistance with the payment process.

- Provide an explanation of charges and/or correspondence.

- Work with Doctors offices and insurance companies to fulfill their requests for demographic information.

- Work with patients that come to the Business Office to resolve their questions or make payments.

**SECONDARY (modifiable)**

- Utilizes the Hospital Information system to research accounts in a timely and effective manner.

- Prepares financial agreements, creditors claims, probate forms, bankruptcy claims and Workers Compensation liens.

- Provides assistance in any area assigned or designated by the Manager or Director.

- Assists in the orientation of new employees.

- Other duties as assigned.

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