DEFINITION:  
The Customer Service Agent works directly with patients and third party liaisons in regards to billing inquiries which include but are not limited to: making payments, setting up payment plans, disputing claims with clinics/departments, setting up payroll deduction for hospital employees, working with third party vendors for balance disputes, investigate and resolve any A/R ledger discrepancies, handling PHI and money handling, applying discounts according to company policies, toggling multiple EHR systems daily, etc.

EDUCATION:  

REGULATORY REQUIREMENTS (IF APPLICABLE):  

MINIMUM QUALIFICATIONS:

PREFERRED QUALIFICATIONS:

  • Must have good organizational skills, reading, writing and proven communication skills.
  • Proficient in Excel.
  • Prefer 2 year of hospital/medical office billing and collections or can demonstrate an understanding of hospital/physician billing and collections.
  • High School Graduate with excellent organizational skills, ability to work independently and stay on task,
  • Ability to learn and understand billing protocol and reimbursement issues, ability to maintain accurate and detailed charts/notes in the company system.
  • Must have at least 2 years of a Medical Office/Hospital billing setting.
  • Medical terminology helpful.
  • Type 50 words per minute and 10-key calculator.

PRINCIPLE RESPONSIBILITIES:

  • Employee has attended departmental orientation (training) and annual inservice education for age specific training and implements in work area what was learned in age specific training.
  • Toggling 4+ EHR systems daily, multiple times a day.
  • Patient Interaction daily (Tracks all patient interactions on a spreadsheet with record of details).
  • Collecting payments daily and ensuring all money handling processes are followed for proper bank deposits.
  • Able to work merchant account for credit cards payments.
  • Prepares all itemized requests that are directly requested from the patient or from our third party vendors.
  • Working monthly payroll deduction lists to ensure our employees are contacted and enrolled in Payroll Deduct for their balances owed.
  • Working daily exception files that are for our employees to ensure they are updated in the system and on the right statement path.
  • Handles disputes that patients have and follows up with the appropriate department to ensure patient has an update within 48 hours.
  • Up to date on all policies which include discounts and paid in full.
  • Knowledgeable and works with all of our third party billing companies including the ones we do not work with directly.
  • Working credit balance reports from statement rejection reports so credits can be redistributed to ensure statements generate and release in a timely manner.
  • Up to date on FQHC regulations and new dental rules to ensure any patient questions are answered knowledgeably.
  • Works a payment plan report for our internal physician billing accounts.
  • Many other special projects that are assigned for clean up or other purposes.

SPECIFIC UNIT/AREA RESPONSIBILITIES:

  • Coordinate with third party agencies and ensure all reports and requests are processed in a timely manner.
  • Responsible for working daily, weekly monthly files as well as any email correspondences.
  • Perform audits to ensure third party agencies are following proper policies and work flow guidelines and are in compliance with hospital standards, policies, and procedures.
  • Identify, research, and effectively communicate any systemic or process issues found; facilitate, communicate, and implement resolutions when appropriate.
  • Serves as a resource to external staff regarding departmental/area policies, procedures and services.
  • Coordinates communication between registration, medical records, and other functions as necessary; contacts the billing agency for missing information and updates the system with new information accordingly.
  • Facilitates communication with care providers regarding documentation opportunities and/or requirements.
  • Provides Third party agencies with all explanations of benefits (EOB's) allowing service staff to follow up on all unpaid accounts.
  • Data Analysis - Collecting, auditing and analyzing spreadsheets. Some data entry required. Ensuring accuracy of data in our internal system. Creating excel spreadsheets and working with our database to create reports. Studying the information to identify trends and opportunities to improve processes and procedures.
  • Support for Third Party Agencies - Coordinate the collection of data and input of data. Research variances and use the information to consult with and educate outside agencies and internal teams. Complete any requests for data or documentation to outside agencies.

WORKING CONDITIONS:

  • Sitting for long periods of time.

PHYSICAL REQUIREMENTS:

HAND AND ARM USE:

  • Must be able to use hands to write, use computer keyboard and 10-key calculator.

LIFTING AND CARRYING:

  • Must be able to carry storage boxes weighing up to 60 lbs.  Must be able to bend, stoop and lift overhead.

PUSHING AND PULLING:

  • Must be able to push/pull storage boxes with a force of 3Slbs.

STANDING/WALKING/SITTING/CLIMBING:

  • Must be able to stand approximately 2 hours a day to file medical documentation.

SENSE OF TOUCH:

  • Must be able to detect heat if equipment should overheat.

HEARING:

  • Must be able to hear conversations, ringing telephones, equipment alarms and overhead speakers.

VISION:

  • Must be able to read handwriting, computer screens and direction signs throughout the facility.

MENTAL REQUIREMENTS:

MATHEMATICS:

  • Must be able to subtract, add, divide and multiply.

MEMORY:

  • Must be able to remember general and specific instructions of job duties.

LANGUAGE ABILITY:

READING:

  • Must be able to write/print clearly. Must be able to read and write at a high school level. Composing phone messages and instructions for co-workers. Communicating verbally with logic to co-workers. Reasonable judgment in locating misfiled files.

WRITING:

  • Must be able to remember general and specific instructions of job duties.

SPEAKING:

  • Job requires ability to speak verbally with logic to patients, physicians and the general public.

REASONING:

  • Job requires judgments in dealing with all phases of secretarial duties.

Lawton

104 NW 31st Street Lawton, Oklahoma 73505

Phone:

580.536.2121

Toll Free:

1.877.231.4440

Fax:

580.536.2150

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