Patient Accounting Call Center Representative

HealthPartners is hiring for a Patient Accounting Call Center Representative working in the Finance department. 

 

 

 

QUALIFICATIONS:

 

REQUIRED TESTING:

 

Patient Accounting Terminology Test

Alpha-numeric data entry 4000

35 WPM

 

REQUIRED:

 

High School Diploma or GED

Two years recent medical billing and collection experience

One year general health care customer service experience

One year experience with automated health care billing systems

One year PC experience including Microsoft Office Suite

Knowledge of basic accounting principles

Knowledge of insurance terminology, medical coding systems (ICD & CPT) and third-party billing and reimbursement procedures

Good communication skills, written and verbal, to establish and maintain effective working relationships, with internal/external payers and customers

Demonstrated ability to work and make decisions independently, perform under deadlines and assume responsibility for problems and problem resolution

Must be detail oriented and have the ability to organize information

Must possess strong analytical and quantitative skills

Flexibility - must be able to perform team duties as required to accomplish departmental goals and meet patient customer needs

Ability to work well under pressure

Strong customer service orientation including a commitment to service and quality with both external and internal customers.

Demonstrated proficiency to maintain confidentiality and handle sensitive and confidential information, per HIPAA and HealthPartners guidelines.

Demonstrated proficiency to deliver information and answer questions in a positive manner to facilitate strong relationships with customers.

Demonstrated proficiency to adapt to new and different situations, read the behavior of others, have difficult conversations with ease, and defuse and resolve conflict.

 

PREFERRED:

 

Working knowledge of the following medical systems: Resolute EPIC

Working knowledge of billing and reimbursement policies of two or more insurance payors.

 

PHYSICAL REQUIREMENTS:

Ability to sit or stand for prolonged periods of time. Oral and written communications with customers requires adequate speech, vision, and hearing. Proficiency in English is required. Proficiency in other languages may be required. Use of a telephone and computer terminal also requires adequate hand writing and manual dexterity skills.

 

 

POSITION PURPOSE:

Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees.  Teamwork is the norm and all employees will be held accountable to work as effective team members. The Patient Account Representative – Call Center is the primary link with the customer involving research, resolving and providing responses to patients, members, prospective members, HP personnel and third party payers on wide variety of subjects, including billing, coverage and services provided at HP. This position is accountable for responding to and resolving customer inquiries regarding billing and payment, accurate and timely resolution of claims, to include denial management, follow-up and third party collections.

 

 

ACCOUNTABILITIES:

 

Responsible for billing follow up/collection on assigned accounts with appropriate payers (i.e. governmental agencies, attorneys, patients, insurance companies) to ensure an acceptable level of outstanding receivables as defined by corporate or department key process measures based on national standards.

Responsible for answering an average of 800 customer service calls per month regarding payments, claims processing, coverage and billing of services provided by HP with compassion, patience, active listening and effective & efficient resolution.

Investigate, respond and resolve/facilitate resolution of all phone and written inquiries from patient/member, third party payers, and attorneys concerning billing, account status, claim status and eligibility issues.

Accountable for ensuring an acceptable level of outstanding accounts receivable, as defined by corporate or department key process measures based on national standards.

Access and understand necessary information via automated membership files, claims inquiry, account histories, account status screens. This includes understanding the systems adjudication process in determining how a claim has been paid.

Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller.

Perform maintenance as needed on the patie