Customer Service Representative PFS

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Responsible for accurate and timely resolution of patient’s billing concerns and for implementing collection policies and procedures. Responsible for interviewing and counseling patients for payment arrangements and/or charity assistance and other assigned duties. Works with patients to resolve account balances.

MINIMUM QUALIFICATIONS :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school diploma or equivalent.

PREFERRED QUALIFICATIONS :

EXPERIENCE:

1. One (1) year experience in a healthcare setting.

2. One (1) year previous customer service experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Accurately posts data (payments, adjustments) as needed.

2. Communicates problems hindering work flow to management.

3. Resolves patient billing and third party payer concerns.

4. Interviews & Counsels patients for payment arrangements and/or charity assistance.

5. Answers patient questions quickly, accurately, and courteously.

6. Accurately identifies and screens Medicare charity within established guidelines.

7. Rebills accounts as necessary.

8. Works with patients to resolve account balances.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized in preforming duties throughout the work shift.

2. Visual acuity must be within normal range.

3. Must be able to exert in excess of 50 lbs. of force occasionally, and/or up to 25 pounds of force frequently, and/or up to 10 pounds for force constantly to move objects.

4. Must have manual dexterity to operate keyboards, fax machines, telephones, and other business equipment.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Exposed to high stress and constant interruptions.

2. Normal business office surroundings.

SKILLS AND ABILITIES:

1. Professional Interactions at all times.

2. Excellent oral and written communication skills.

3. Knowledge of medical terminology preferred.

4. Knowledge of ICS-9 and CPT coding preferred.

5. Ability to use tact and diplomacy in dealing with others.

6. Demonstrated customer service relations.

7. Analytical skills necessary for problem solving.

8. Knowledge of Fair Debt Collection Act.

9. Specialized courses or seminars over and above high school that are directly related to collections, medical field, hospital business office setting.

10. General knowledge of third party payers, collection laws, and collection procedures required.

12. Excellent telephone communication skills.

13. Working knowledge of computer including Microsoft Word and Excel.

14. Demonstrates the knowledge and skills necessary to communicate to all patients per the established age specific education/standard.

15. Maintains current knowledge of Medicare reimbursement process and audit regulations.

16. Understands the UB92/1500 bill forms contents and EOMB’s.

17. Ability to understand written and oral communication.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

656 SYSTEM Customer Service