Customer Service Specialist, Patient Accounts

Customer Service Specialist, Patient Accounts

POSITION SUMMARY

This position is responsible for responding to patient account questions, resolving product or service concerns, and clarifying customer complaints received web portal, by telephone, and in face-to-face interactions. Role includes actively listening, researching and analyzing problems, identifying potential solutions, and expediting corrections or adjustments.

RESPONSIBILITIES AND ACCOUNTABILITIES

Customer Service :

• Promote a patient-centric approach to resolving patient account balances.
• Engage with patients in various platforms including EMR portal messages, telephone calls, and in face-to-face communication.
• Perform inbound telephone coverage to answer account questions for patients / families. Calculates and collects payments appropriately for all patients.
• Performs duties necessary to ensure all accounts are processed accurately and efficiently.
• Reconcile claims issues and requests refunds when appropriate.
• Provides support to the scheduling department in identifying in-network insurance contracts and reimbursement policies.
• Research accounts receivable issues as required and directed.
• Process guarantor corrections due to registration errors and updates insurance information on file as needed.
• Works effectively with team and leadership to make suggestions about improving workflow and providing excellent service experiences.

Communications :

1.Communicates with patients, insurance carriers and other outside entities in a professional manner. Identifies solutions and responds professionally to patient concerns, i.e., pleasant tone of voice, courteous language, etc. Uses appropriate grammar and demonstrates tact and diplomacy in patient interactions, by phone and in person.

2. Diffuses negative situations with patients and maintains a pleasant and professional tone during stressful circumstances and heavy workload.

3. Communicates with staff members in a professional, pleasant manner; Shares information relevant to work, no gossiping or disparaging remarks, accepts work without complaint or provides reasons why assignment is unmanageable, asks and answers questions related to improving department performance.

TEAMWORK

Teamwork :

Willingly provides coverage, volunteers assistance, and maintains workflows within department as needed without direct instruction / supervision.

Works cooperatively and refrains from participating in negative conversations.

Shares knowledge and insights with co-workers in a constructive manner.

Works to solve problems and address conflicts with appropriate person directly before involving leadership or uninvolved peers.

Is considerate of others in the work environment with regard to taking breaks or meal periods, use of computer and phone, noise level in the department, etc.

POLICIES AND PROCEDURES

Policies and Procedures

Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents.

Provides assistance and support to leadership in implementing policies and procedures as necessary.

Actively participates in training, and conducting day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs.

QUALIFICATIONS

Education, Experience, Certification and Licensure Requirements :

High school diploma / GED required. 1 to 3 years of previous customer service experience required, including billing / collections experience in a medical office setting.

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