Customer Service Representative

Customer Service Representatives are responsible for answering telephone calls, assisting callers with insurance billing questions and pursuing patient debts.

Essential Functions

Adheres to the Keralty Hospital goals and values providing exceptional customer service at all times.

Uses proper phone etiquette: tone of voice / smile while on the phone. Speaking to callers with respect and empathy.

Reviews patient accounts and insurance claims processing in detail to ensure validity of balance and rectifies any discrepancies.

Documents details of all conversations and activity on the account in the notes of the patient chart in a clear and professional manner as it pertains to billing and collections.

Answers calls promptly by third ring and attempts to resolve on first contact. Transfers appropriately when unable to complete independently.

Retains confidentiality about patient issues and concerns, never discussing with other co-workers.

Assists in review of patient statements for accuracy and identifies trends of patient collections.

Pursues all patient debts on AR with a sense of urgency.

Aides in export of past due patient accounts to outside agency.

Supports internal customers with billing questions.

Responds in a timely fashion to all billing messages and correspondence.

Assists with daily balancing of patient collections.

Brings issues to supervisor as necessary to resolve issues.

Takes on additional projects as assigned.

Works well in a team environment to accomplish common tasks in a collegial manner.

Experience Required

Familiarity with insurance rules and regulations preferred

Previous billing experience preferred

Analytical skills required

Ability to problem solve

Skills and Abilities

Use language and mathematical skills to analyze and interpret reports and related material.

Recognize errors in recorded information.

Perform routine and repetitive work.

Knowledge of 3M Encoder.

Medical Terminology.

Principles of disease.

Use of appropriate ICD-10 codes and CPT, Current Procedure Terminology, for diagnosis and procedures.

Anatomy and Physiology.

Medical Terminology.

Physical Demands

Light Work: Exerting up to 20 pounds of force occasionally for up to 1/3 of the time and/or up to 10 pounds of force occasionally for up to 1/3 of the time to move objects. Requires walking or standing to a significant degree, or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls, or requires working at a production rate pace entailing the constant pushing and/or pulling of material even though the weight of those materials is negligible.

Environmental Conditions

Inside: Protection from weather conditions but not necessarily from temperature changes.

Reasoning Development

Apply principles of rational systems to solve practical problems and deal with a variety of concrete variables. Interpret instructions furnished in written, oral, diagrammatic form.

Mathematical Development

No special computation skills are necessary. Basic mathematical skills and concepts will be utilized for patient payment needs and calculate their care expenses.

Language Development

Reading: Read and understand instructions, safety rules, legal documents and the components of medical records.

Writing: Write reports with proper format, punctuation, spelling and grammar, using all parts of speech.

Speaking: Speak with poise, voice control, and confidence, respect, using correct English and well-modulated voice.

Relationships to Data, People and Things

Data: Compiling: Gathering, collating or classifying information about data, people, or things. Reporting and/or carrying out a prescribed action in relation to information are frequently involved.

People: Speaking-Signaling: Talking with and/or signaling people to convey or exchange information.

Things: Operating-Controlling: Starting, stopping, controlling and adjusting the progress of machines or equipment. Operating machines involves setting up and adjusting the machine or materials as the work progresses. Controlling involves observing progress of operations and turning devices to regulate reactions of materials.