CBO Customer Service Rep I: Austin Regional Clinic

PURPOSE: Assists incoming callers/patients with billing inquiries while providing excellent customer service. Carries out all duties while respecting patient confidentiality and promoting the mission and philosophy of the organization supported.

ESSENTIAL FUNCTIONS:

Customer Service

· Receives inbound telephone calls from internal and external customers. ie. Patients, Insurance Representatives.

· Asks appropriate verification questions prior to releasing confidential patient information in accordance to company policy/HIPAA guidelines.

· Reviews explanation of benefits documents with knowledge and ability to explain information to patients/customers.

· Provides financial counseling service/payment arrangements to walk-in patients with outstanding account balances.

· Maintains and follows up on work queue accounts in a timely manner and documents all actions with clear and accurate documentation.

· Receives patient refund request information and forwards to Refunds processing.

· Requests information from Clinics and follows up in a timely manner.

· Returns telephone calls from Customer Service voicemail message line within timeframes established by department.

Account Transactions/Insurance

· Reviews account transactions for accuracy and distributes patient credits.

· Uses appropriate transaction and ANSI codes per Posting guidelines.

· Reviews and documents patient correspondence. Contacts patients to acknowledge receipt of correspondence in a timely manner, whenever necessary.

· Obtains updated insurance information and forwards to the Registrations unit for eligibility verification.

· Follows up with insurance carriers on payments and adjustments whenever necessary in order to resolve patient issues. Refers accounts to the Appeals unit, if applicable.

· Reviews automated claim forms and edits as necessary to reflect complete, accurate information.

· Utilize Payor Websites efficiently and maintain confidential security passwords.

Collections

· Receives credit card payments via telephone and forwards information to the Posting Unit for processing.

· Establishes payment plans per Payment Agreement guidelines.

· Works closely with Collections Department and/or directly with Customers on payment of balances due.

· Sets up accounts with payment plan information and clearly documents the terms of the agreement.

· Reviews automated claim forms and edits as necessary to reflect complete, accurate information.

· Consults with Supervisor prior to offering discounts for non-covered services.

· Return telephone calls left on Customer Service voicemail message line within timeframes established by department.

OTHER DUTIES AND RESPONSIBILITIES:

· Keeps complete, accessible, and current billing information.

· Provides assistance to coworkers as requested and/or necessary.

· Provides workload/productivity reports to management team.

· Responds professionally and effectively to questions from external sources, i.e., customer or carrier, and internal sources, i.e., provider or management team.

· Attends required inservices/training sessions/department meetings.

· Meets performance competency standards for Registrations, Posting and Follow up.

· Performs other duties as assigned.

MINIMUM QUALIFICATIONS:

Education: High school diploma or GED equivalent.

Skills/Experience:

· Experience using computer data processing systems.

· Must have excellent verbal and written communication skills in order to communicate

clearly and effectively to all levels of staff and the public.

· Prefer 6 months previous customer service experience in medical billing.

· Prefer knowledge of and/or experience with CPT and ICD-9 coding.

· Prefer knowledge of legislative and private sector third party regulations and guidelines.

· Ability to sit for extended periods of time at a computer workstation.

· Ten key by touch preferred.

· Bilingual/Spanish preferred.