Lead Patient Financial Services Customer Service Representative

Job Overview

This position is responsible for providing Fairview Health Services patients an understanding of the billing and insurance processing of their healthcare services. The CSC Representative Lead will provide training and oversight for staff regarding the financial solutions available to our patients either through direct payments, payment plans, or screening for qualification for assistance programs. The Lead is the first point of escalation regarding complex patient inquiries and disputes. The CSC Representative Lead will oversee the collection process for both hospital and physician accounts in all systems and understand in depth the Registration, Hospital Billing, and Clinic Billing functions that are necessary to resolve accounts including negotiation of settlements and payment arrangements. They will have detailed knowledge of the Functions within the Revenue Cycle and how they interact in the life of a patient account. They will also be responsible for overseeing the pre-registration processes for Hospital visits and will be well versed in our auto-dialer functionality.

 

• Monitors the best practice routine per department guidelines.
  • Monitors calls to ensure that quality standards are followed for calls presented to CSC through automated call distribution system and auto-dialer. Able to work independently with CSC Representatives and patients in resolving questions and concerns.
  • Escalation point for patient calls that need to be referred when patient requests or staff identify need.
  • Ensures patient and/or guarantor understand co-pays/deductible/ coinsurance and insurance benefits. Place calls as needed to insurance companies with patient/guarantor when indicated.
  • Work independently in problem solving with patients and/or staff regarding accounts in both hospital and clinic billing situations. Counsel the patient on the complexity of the interdependency between hospital and physician billing within the patient’s continuity of care.
• Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices.
  • Understanding of multiple payers in both hospital and clinic services.
  • Ensures staff understands how to reviews explanation of benefits for accuracy in posting and assisting patient’s with understanding their patient liability.
  • Manage problem accounts and work towards timely resolution of issues.
  • Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.
  • Train staff to ensure that both hospital and clinic information for patients is accurate.
• Manage accuracy of accounts to insure appropriate billing and compliance with patient privacy and data integrity.
  • Monitors staff can verify insurance benefits to maximize reimbursement and timely submission of claims. Monitors staff for registration accuracy.
  • Gathers data, summarizes, and prepares reports for management and completes special projects as assigned
  • Work independently to manage special projects either identified by the lead or as assigned by CSC management.
  • Through call monitoring ensure that staff can assist all customers regarding billing questions and ensures appropriate resolution of problems. Train staff to insure they can explain and interpret eligibility rules and regulations or identify other resources available for financial assistance. Identify patients who may be eligible for financial exceptions. Keep updated on changes with regulatory issues.
  • Manage staff’s ability to validate accurate patient data and identify that proper authorization is in place to provide information.
  • Participates in planning weekly staff meetings for CSC to ensure that staff is receiving necessary information in a timely manner.

Required

• 3 years customer service experience with 1 of those years in healthcare customer service

Preferred

• Associates Degree
• 1 year of working with customer complaints or disputes
• strong interest in learning new IS systems (PASS, Deloitte overlay system, Healthworks, etc.)
• ability to work independently

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical.
EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Qualifications:

$24.77-$34.97 / Hourly

Salary : $25 - $35