The Patient Services Representative will work with patients to find a satisfactory means to collect unpaid balances in a timely manner. The Patient Services Representative will assist patients, physician offices, and insurance companies with questions concerning billing activities on patient accounts. Answer calls from internal and external clients and patients to meet or exceed performance standards including but not limited to answer rates, handle time, wait times and quality of calls. Understanding the importance of Quality Service and how it is measured and the ability to perform with a team to achieve daily goals and complete tasks.
- Explain patient bills including charges, insurance allowable, adjustments, coinsurance, and payments
Contact patients to reconcile past due accounts and/or establish a payment plan.
Provide feedback to patients and families regarding their concerns and complaints
Review and work collection accounts, including but not limited to proactively identifying potential billing errors and researching, making corrections as appropriate.
Process mail returns to obtain new address information.
Prepare and process bankruptcy and probate requests.
Process accounts to be turned to collection agencies.
Handle heavy call volumes.
Correct any errors on the patient's accounts when encountered.
Research and reconcile problems concerning payments and charges and insurance billing.
Correct/update insurance information and file claims as appropriate
Make adjustments as requested by the physician's office concerning patient accounts or billing information.
Respond to patients/insurance requests generated through phone calls.
Document accounts with actions taken/patient requests
Work incoming patient correspondence related to billing concerns
Observe and report new trends or unusual billing issues to Supervisor.
Proactively review account when working with patients in order to prevent future issues.
Review Credit Balances at the invoice level and make appropriate corrections and/or process for refunding.
Other related duties as assigned.
Minimum Education and Experience:
- High School Diploma or GED required; associates degree preferred
- 2 years Customer Service Experience, healthcare industry a plus
- Minimum one-year phone related customer service experience required
- Proficiency with Microsoft Windows, Word, and Excel applications
- Experience in a medical office or primary care office is ideal
- Knowledge of Medicare insurance preferred
- Previous collection experience (medical collections preferred).
- Previous medical billing/insurance processing experience
Established knowledge of all insurances and billing/reimbursement procedures.
Strong organizational and research skills.
Ability to work independently to maintain high productivity.
Strong communication and customer services skills.
Basic knowledge of PC's to include keyboarding as well as software programs such as Word and Excel.
Excellent verbal, written, math and problem solving skills.
Proven ability to remain calm, courteous, and professional at all times and with all telephone calls.
Basic Knowledge of CPT codes and diagnosis codes.