What are the responsibilities and job description for the Medical Billing and Insurance Specialist position at SCA Health?
About SCA Health
Today, SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU. We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business. We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
The Job Description
The Patient Call Representative role involves taking inbound calls from patients and making outbound calls to resolve their inquiries. The rep receives and/or collects payments and resolves the issue either through a one call interaction or by escalation and follow-up.
- Taking inbound calls from patients and making outbound calls to resolve their inquiries
- Providing one call resolution to patient inquiries whenever possible and performing timely follow-up on inquiries requiring escalation or additional research
- FOLLOWING UP ON ALL PATIENT VOICEMAILS WITHIN 24 HOURS
- Providing patient education regarding how to understand their Explanation of Benefits (EOB)
- Taking payments from patients
- Providing requested documentation and records
- Consistently achieving defined metrics
- Reading and understanding contracts with insurance companies
- Reviewing and determining if an adjustment is required on an account
- Reviewing and determining if a refund is required on an account
- Verifying insurance
- Providing patient estimates
- Verifying and updating demographic information
- Researching and locating missing payments
- Reviewing clinical information to determine if a coding review is required
Requirements
- High school diploma or GED required
- Strong customer service experience preferred
- A/R, billing, insurance verification or customer service experience preferred
- Healthcare experience preferred
- Bilingual preferred
