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Customer Service Representative (MedStar Physicians' Billing Services)

Company: Medstar
Location: Arlington
Posted on: May 3, 2021

Job Description:

MedStar Physicians' Billing Services is currently seeking experienced Customer Service Representatives to join our call center team. On-site training in Arlington, VA required for the first 90 days of employment. After training, associates get to enjoy a remote work schedule, Monday - Friday, 9:30am - 6:00pm.Job Summary As the primary post-service contact for most all MedStar Physicians' patients, identifies the nature of inquiries, discerns potential implications for other external entities (MedStar and non) and uses multiple internal/external resources, applications and processes to resolve cases. Researches, analyzes and follows up on cases as required. Provides a single point of contact from origin through final resolution for all patient billing, coding, service and insurance concerns. Maintains professional and courteous behavior to ensure positive image within the community served and to enhance the patient experience. Uses appropriate MedStar and MPBS guidelines to make best practice decisions concerning proper resolution of each individual case with special emphasis on building rapport, enhancing the patient experience and service recovery. Is entrusted with an above-average level of system training, access and independence such that over 85% of all patient inquiries will be resolved at the level of this single point of contact. Assists management with the training of new hires. Contributes to and works in an ACD Call Center team environment, mindful of traffic patterns and meeting established standards. Minimum Qualifications Education/Training High School Diploma or equivalent. Associate's or Bachelor's Degree strongly preferred.Experience 3 years experience in patient accounting or related healthcare field, or 2 years Customer Service experience or an equivalent combination of experience and college education in Accounting, Finance or Healthcare Administration.License/Certification/Registration CPAT (Certified Patient Accounting Technician) certification preferred.Knowledge, Skills & Abilities Able to work in a team-oriented call center work environment. Advanced ability to handle challenging personalities and ability to diffuse confrontational situations. Advanced organizational, analytical and research skills. Able to apply policies and guidelines effectively to make sound, independent decisions concerning repetitive cases and exercise good judgment in advocating and making appropriate recommendations. Highly developed interpersonal and verbal and written communication and service delivery skills in order to successfully handle disgruntled and confused patients. Proficient use of GE IDX registration and/or billing systems. Computer literacy, with experience in GE IDX and/or SMS Invision strongly preferred. Proficient in use Microsoft office products. Detailed working knowledge and demonstrated proficiency in major payers application billing and collection processes, with particular focus on payers submission/resubmission requirements. Knowledge of managed care contractual arrangements and insurance verification and pre-certification authorization guidelines. Comprehensive understanding of ICD9/10 and CPT coding. Knowledge and experience with HCFA1500 physician billing with some UB04 hospital billing understanding preferred. Ability to type 35 wpm. Primary Duties and Responsibilities Advocates on the patients behalf in order to achieve proper, warranted best results and gain patient favor (other MedStar depts. and entities, collection agencies, web site vendors, outside labs, etc).Answers and resolves patient/guarantor inquiries daily, via telephone, mail, fax, web or in person. Able to handle at least 35 daily incoming questions and/or service-related concerns, meeting team- specific benchmarks as it applies to interdepartmental issues, special handling, and response time to customers.Applies knowledge of MedStar Managed Care contracts and the associated rules for claim processing in order to achieve proper reimbursement and customer satisfaction.Attends training sessions, workshops offered, staff meetings and work events.Communicates to MPBS leadership any system or procedural problems/inconsistencies to prevent problem recurrence and/or to improve existing processes.Completes annual mandatory training (SITEL) within defined time frame.Corrects invoices and accounts that have erroneous registration and/or insurance information and ensures that all associated claims have the correct financial classification for timely processing or reprocessing.Exemplifies Spirit Values in all activities in areas of service, resource utilization, high quality outcomes and effective communication.Interviews (via phone and/or in person) patients in need of referral or recommendation to appropriate support and/or charity care programs. Proposes budget/payment plans to customers as the situation warrants and in accordance with MPBS standards and procedures.Keeps abreast of regulatory and specific changes as it relates to HCFA 1500 billing requirements and payer-specific follow up.Maintains departmental QA standards within established error rate.Meets the established standards for abandoned calls, duration of calls and the amount of time that patient is held in queue, etc.Remains the single point of contact for the patient: Liaises, advocates, researches and analyzes documents, records, prior precedent-setting cases, discussing and reviewing with both internal and external sources, etc, until final adjudication or resolution is achieved.Updates GE IDX after each inquiry to ensure proper documentation of inquiries and resolutions.Uses established guidelines to make independent decisions concerning specific patient issues in need of resolution, therefore building trust and rapport with patient population.Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.Performs other duties as assigned.About MedStar Health MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.

Keywords: Medstar, Arlington , Customer Service Representative (MedStar Physicians' Billing Services), Other , Arlington, Virginia

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