Job Category:

Administrative & Clerical

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

The Customer Service Representative II is responsible for handling high volumes of inbound and outbound patient billing calls, addressing inquiries and complaints related to professional and facility services. The role requires courteous and efficient communication, accurate documentation, timely issue resolution, and escalation to leadership when needed, while keeping patients informed throughout the process. The Customer Service Representative II is responsible for managing high volumes of inbound and outbound patient billing calls. This role involves explaining insurance responsibilities, communicating denial reasons, and helping patients understand the medical billing process for services rendered. The CSR II resolves billing inquiries and complaints, and ensures accurate documentation of all interactions.

Minimum Job Qualifications

• Licensure or other certifications: GA HMFA Certified Patient Account Representative (CPAR) Certification

• ​Educational Requirements: High School Diploma or GED

• Minimum Experience: Three (3) year minimum medical billing or collection experience.

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements:

• Preferred Experience:

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Solid knowledge of Revenue Cycle functions, including registration, authorization, and insurance billing.

• Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently.

• Excellent listening and problem-solving skills with attention to details.

• Excellent customer service skills and ability to remain calm and professional in stressful situations.

• Excellent verbal and written communication skills.

• Ability to work independently within guidelines.

Essential Tasks and Responsibilities

• Accepts all calls via the ACD (Automated Call Delivery) lines in a manner that keeps wait times to a minimum. Identifies self by name and department, handles call in professional manner, asks if all issues resolved and if anything else may be needed prior to ending call.

• Reviews accounts thoroughly, verifying balance to be correct. Performs required action to correct balances found to be in error. Refers errors to other departments for assistance only when appropriate.

• Analyzes all details of account for accuracy and resolves all insurance questions including payment, adjustments and benefits.

• Researches all patient complaints and inquiries in a timely manner, keeping patient informed of progress when other departments must be consulted.

• Follows required insurance billing processes

• Follows all department and NGHS guidelines, policies, and standard work.

• Remains in good standing with all NGHS policies including those related to attendance, positive attitude and staff development.

• Maintains an understanding of health insurance and EOB's, collection processes and techniques, and NGHS Financial Assistance Programs .

• Performs other duties as assigned.

• Documents the patient account thoroughly and accurately in order to leave sufficient information for any other party reviewing the account for future collection efforts, which may include presentation in court.

• Ability to thoroughly review and understand all documentation in the NGMC Patient Accounting EMR system.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Occasionally 0-30% of time

• Kneeling/Stooping/Bending: Occasionally 0-30%

• Standing/Walking: Occasionally 0-30%

• Pushing/Pulling: Occasionally 0-30%

• Intensity of Work: Frequently 31-65%

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in y