Job description

The Reimbursement Resource Customer Service Representative is responsible to provide support to patients, providers, and customers internally and externally on billing related inquiries. The employee works insurance claims and patient accounts using department guidelines and MPG/PFP electronic systems. The position requires a thorough knowledge of insurance carrier billing and reimbursement, CPT, ICD10, modifiers and fee schedule differences. This requires understanding of how to decipher explanation of benefits and explain the impact to the customer. Position requires the ability to conduct both telephone and face to face meetings with patients regarding account resolution and payment collection as well as via portal messaging. Assist customers with hardship applications, payment plans and eligibility for services Expert verbal communication, interpersonal skills and professional appearance required for dealing with customers. Additional duties required.

Standards of Job:

· Demonstrate excellent interpersonal skills with patients, co-workers, and insurance carriers

· Well-versed with HIPPA Guidelines to ensure the protection of patient information from unauthorized inquiries.

· Process and post payments to accounts same day

· Resolve patient complaints within a minimal timeframe, same day whenever possible.

· Meet timelines for reprocessing Athena claims after updating the account with new information as provided by patients or physicians within the guidelines and timeframes permitted by the insurance carrier.

· Advanced knowledge of CPT, ICD10 and modifiers.

· Phones answered and voicemails returned within same day.

· Claim adjudication carrier rules knowledge.

· Conducts themselves in accordance with MPG/PFP Policies and Procedures including the Code of Conduct.

· Meets or exceeds monthly performance goals, expectations, and reviews

· Uses PTO effectively

· Keeps overtime to a minimum/any overtime is approved by Manager

· Communicates call trends to management when needed for possible escalation

· Actively participates in team meetings and educational opportunities.

· Perform other duties as required

Skills and Abilities:

· Excellent written and verbal communication skills

· Proficient with MS Office and ability to navigate multiple platforms

· Strong customer service skills with the ability to resolve patient concerns

· Assurance standards, you’ll focus on the patient first, be accountable, and play an important part in creating a superior patient experience.

Qualifications:

• High School diploma, GED or suitable equivalent
• 2+ years’ experience in healthcare customer service
• Excellent verbal and written communication skills, including but not limited to email and telephone etiquette
• Proficient with MS Office and Excel
• Bilingual in Spanish is a plus but not required

Reports to: Revenue Cycle Manager

Job Type: Full-time

Pay: $16.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Austin, TX 78746: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Required)

Experience:

• Revenue Cycle Customer Service: 1 year (Preferred)
• Microsoft Office: 1 year (Required)

Work Location: One location

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