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The Customer Service Representative is responsible for timely and accurate responses to all calls and email inquiries received via the PFS Customer Service phone line and email systems. Assists with deceased patient accounts, bankruptcy determinations, and attorney requests for information. This position also assists with receipt and distribution of PFS correspondence. This position requires excellent customer service to all internal and external customers and requires good communication skills to resolve any patient concerns.
Required Knowledge & Skills
Education: High School Diploma or GED
Experience: Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Licenses and Certifications
NONE REQUIRED
Supervision
None required
Qualifications
Business-like appearance. Neat and pleasant demeanor with the ability to communicate with a variety of people of different backgrounds. Ability to work closely with others, and function as a team member. Ability to analyze and prioritize workloads. Ability to be assertive without being abrasive. Two (2) years experience in patient accounting. Must be able to spell and write business letters which are effective, and grammatically correct. Knowledge of spreadsheets and word processing helpful but not required. Detail oriented. Good verbal communication skills.
Statement Of Employment Philosophy
Being a part of Tanner Health System is more than a job, it is a promise we make to treat every patient with exceptional service every time they walk through our doors. Service excellence is the foundation of our organizational culture and the expectations we all set for each other, our patients, physicians and our community. All employees agree to abide by a set of service standards. These standards are the promise we make to provide the best care possible, and represent our beliefs, values and who we strive to become. We each commit to making Tanner Health System a great place for our employees to work, for patients to receive care and for physicians to practice medicine.
Functions
Area of Responsibilities
Provides comprehensive customer service functions, which includes responding to patient calls, MyChart requests, email inquiries and complaints from all sources in a timely and thorough manner. This function requires extensive customer service interaction with patients, internal departments, vendors, physician offices and attorneys. Responds to all customers using kindness, compassion and empathy and in a timely manner.
Responds to all patient concerns and complaints submitted via phone call, MyChart message, email, correspondence or vendor request. Requests received involve disputes with charges or care, requires checking eligibility and loading insurance plans, reviewing and researching patient liability amounts, denials and variances. Complaint review requires thorough research of the account to determine root cause and involves communication with Risk Management and other internal external departments to thoroughly resolve the patient's concern. Maintains tracking spreadsheet of all concerns and ensures consistent follow up of the work queue within the host system. This responsibility requires timely responses to all parties to ensure patient satisfaction is met or exceeded.
Assists with receipt and distribution of all correspondence related to the Revenue Cycle. Scans and indexes any relevant patient information to the Hospital Account Record in Epic. Assists with timely processing of returned mail. This function may require calls to patients, next of kin, doctor's office personnel, employers, or other sources of skip tracing information. Utilizes the Accurint website to check for updated patient addresses. Updates the Hospital Account Record in Epic upon receipt of corrected patient demographic information.
Responsible for receipt and response to attorney requests for information in an accurate and timely manner. Ensures the appropriate HIPAA authorization form is received with the request. Responds to all requests using department policy and ensures the accuracy of documents provided. Requests for medical records and bills will be forwarded to our internal team for review and processing. Responsibilities may also include research of liens filed from within the hospital system or external vendor.
Reviews and processes all Chapter 7 and 13 bankruptcy determinations received by the hospital locations. Applies necessary adjustments to all impacted accounts based on departmental policies and processes.
Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.
Compliance Statement
Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.
Required Knowledge & Skills
Education: High School Diploma or GED
Experience: Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.
Licenses and Certifications
NONE REQUIRED
Supervision
None required
Qualifications
Business-like appearance. Neat and pleasant demeanor with the ability to communicate with a variety of people of different backgrounds. Ability to work closely with others, and function as a team member. Ability to analyze and prioritize workloads. Ability to be assertive without being abrasive. Two (2) years experience in patient accounting. Must be able to spell and write business letters which are effective, and grammatically correct. Knowledge of spreadsheets and word processing helpful but not required. Detail oriented. Good verbal communication skills.
Definitions
The Customer Service Representative is responsible for timely and accurate responses to all calls and email inquiries received via the PFS Customer Service phone line and email systems. Assists with deceased patient accounts, bankruptcy determinations, and attorney requests for information. This position also assists with receipt and distribution of PFS correspondence. This position requires excellent customer service to all internal and external customers and requires good communication skills to resolve any patient concerns.
Position Responsibilities
Contact with Others: Requires frequent contact with many persons at different levels inside and outside of the organization to carry out organization policies and programs and obtain willing acceptance, consent, or action.
Effect of Error: Probable errors not easily detected and may adversely affect external as well as internal relationships and may result in major expenditures for equipment, materials, or procedures detrimental to the patient's welfare or the organization's interest. Work is subject to general review only and requires considerable accuracy and responsibility. Continually works with reports, records, plans, and programs of a major functional area of the organization where integrity is required to safeguard the organization's position. Duties may involve the preparation of data on which the administration bases important decisions and are highly confidential.
People Management Responsibilities
Supervisory Responsibility: Exercises no supervision, work direction, or instruction of other employees or students
Work Environment/Physical Effort
Mental Demands: Work involves a variety of problems in a general field, some of which are complex. Involves some independent judgment to decide what to do to assemble facts, determine variations from standard procedures, or plan other action to be taken to meet general objectives.
Working Conditions: Generally pleasant working conditions/normal office environment.
Working Conditions Aspects for Immunizations
Performs tasks involving contact with blood, blood-contaminated body fluids, other body fluids, or sharps (needles): No
Directly works with Patients less than 12 months of age: No
Physical Effort: Minimum physical effort - Physical demands encountered are those of a typical office job.
Physical Aspects
Bending: Not required
Typing: Constant = 67% - 100% of the time.
Manual Dexterity -- picking, pinching with fingers etc.: Constant = 67% - 100% of the time.
Feeling (Touch) -- determining temperature, texture, by touching: Not required
Hearing: Constant = 67% - 100% of the time.
Reaching -- above shoulder: Occasional = 1% - 33% of the time
Reaching -- below shoulder: Occasional = 1% - 33% of the time
Visual: Constant = 67% - 100% of the time.
Color Vision: Constant = 67% - 100% of the time.
Speaking: Constant = 67% - 100% of the time.
Standing: Occasional = 1% - 33% of the time
Balancing: Not required
Walking: Occasional = 1% - 33% of the time
Crawling: Not required
Running - in response to an emergency: Occasional = 1% - 33% of the time
Lifting up to 25 lbs.: Occasional = 1% - 33% of the time
Lifting 25 to 60 lbs.: Not required
Lifting over 60 lbs.: Not required
Handling -- seizing, holding, grasping: Frequent = 34% - 66% of the time
Carrying: Occasional = 1% - 33% of the time
Climbing: Not required
Kneeling: Not required
Squatting: Not required
Tasting: Not required
Smelling: Not required
Driving -- Utility vehicles such as golf carts, Gators, ATV, riding lawnmowers, skid steer, aerial lift: Not required
Driving -- Class C vehicles: Not required
Driving -- CDL class vehicles: Not required
N95 Respirator usage (PPE): Not required
Hazmat suit usage (PPE): Not required
Pushing/Pulling -- up to 25 lbs.: Occasional = 1% - 33% of the time
Pushing/Pulling -- 25 to 60 lbs.: Not required
Pushing/Pulling -- over 60 lbs. : Not required