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Customer Service Representative -HC

Fairview Health Services Minneapolis, MN
  • Expired: July 12, 2019. Applications are no longer accepted.

The Customer Service Representative (CSR) is responsible for responding and providing information to patients and employees regarding billing questions and concerns. The CSR informs patients regarding billing and insurance processes. Performs insurance and patient pay billing and collections, maintaining acceptable accounts receivable balance(s). The CSR verifies payer explanation of benefits and remittance advice for claims and assigns applicable appeals, following payer guidelines.


  • Serves as a resource for billing/insurance processes for patients and employees.
  • Explains patient/payer responsibilities and obligations.
  • Responds to staff inquiries for account restrictions.
  • Ensures that incoming call volumes are processed expeditiously.
  • Ensures that incoming correspondence is processed expeditiously.
  • Ensures that all written responses are clearly and professionally communicated.
  • Notifies patient and/or guarantor of co-pays/deductible/coinsurance.
  • Performs, understands and can explain functions related to account balancing.
  • Performs basic accounting procedures.
  • Explains to patient and payer details of account balancing.
  • Processes account maintenance adjustments and transfers.
  • Processes insurance claims and patient statements.
  • Verifies patient demographic and insurance information.
  • Verifies insurance eligibility via on-line access or by phone.
  • Reviews payer explanation of benefits and remittance advice for patient claim payments.
  • Collects patient-responsible co-pays, co-insurance, and deductible charges from the patient and/or responsible party.
  • Processes electronic payments.
  • Processes collection agency payments.
  • Review, process, and distribute mail. Resolve mail returns.
  • Document mail returns, address corrections and re-address correspondence for mailing.
  • Document deceased information and handle filing of probate papers.
  • Document filing and discharge/dismissal of bankruptcies.
  • Investigates payer rejections/denials and generates appeals according to payer guidelines.
  • Verifies accuracy of claim information by performing on-line verification.
  • Reviews medical record for claim information.
  • Contacts payer for rejection clarification.
  • Provides payer with additional information as requested for claim resolution.
  • Collections
    • Contacts patients or responsible individuals to discuss delinquent accounts.
    • Investigates and corrects errors in billing accounts to ensure records are accurate.
    • Contacts attorneys, insurance companies, employers, etc., to obtain and provide information necessary in handling credit and collection matters.
    • Evaluates patients’ financial status and establishes payment plan; reviews accounts for possible referral to collection agency.
    • Assigns approved accounts to an outside collection agency.
    • Responds promptly and accurately to patient inquiries or complaints.
  • Processes and respond to patient correspondence, including but not limited to letters and emails from patients, insurance companies and other departments within Fairview.
  • Documents billing information in a timely manner using established note guidelines.
  • May assist in completing other functions within Pharmacy Business Office as necessary.

Required Experience

  • One year of recent insurance and patient-pay billing experience
  • Knowledge of third party payers, billing procedures and insurance.

Preferred Experience

  • 2 + years recent insurance and patient-pay billing experience.
  • Previous experience with insurance claims and private pay processing in a medical office setting.

 Additional Requirements 

  • Excellent customer service and communication skills.  
  • Ability to work independently and exercise independent judgment.
  • Ability to prioritize and deal with fluctuation in workload.
  • Good computer and telephone skills.

Fairview Health Services

Address

Minneapolis, MN
USA