Patient Services Support Services Representative

This position handles all in-depth research regarding patient’s self-pay, insurance and/or bad debt balances and be familiar with a variety of the field's concepts, practices, and procedures, including patient and insurance billing and relies on extensive experience and judgment to plan and accomplish goals.

The core responsibilities of a Support Service Representative are to perform account research, insurance/adjustment identification to ensure proper account resolution and provide proper feedback to all departments within 24-48 hours of receipt of the request. This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience, and flexibility. Support Service Representatives rely on guidelines established by the organization to perform job functions and work under general supervision in a moderately fast-paced environment. Support Service Representatives usually report to the department lead or supervisor.

CORE RESPONSIBILITIES & JOB FUNCTIONS

Core responsibilities include but are not limited to the items listed below:

• Provide Patient Friendly Customer Service


• Correspondence review, both patient and insurance


• Review and Interpret Patient Statements, Account Balances


• Obtain Supporting Documentation Regarding Patient/Client Follow-up Efforts


• Identify Contractual & Administrative Adjustments


• Assist & Resolve Patient Inquiries/Requests in a 24-48 Hour Period


• Assist with Training of Team Members


• Assist with Special Projects


• Other duties as Assigned

EDUCATION & WORK EXPERIENCE:

• High school diploma or equivalent.


• A minimum of two years of previous work experience as an insurance or customer/client service representative is desired.


• Must have a full understanding of insurance billing and insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid, and Commercial Practices), and well-developed interpersonal skills.

MIMNIMUM JOB KNOWLEDGE & SKILLS REQUIRED:

• Excellent verbal and written communication skills


• Reliable attendance record


• Good problem-solving skills


• Ability to learn/stay abreast of relevant policies


• Computer literate / able to use basic functions of a computer


• Ability to type a minimum of 30 wpm


• Detail oriented and well organized


• Ability to perform under pressure in a calm manner


• Basic math skills


• High degree of accuracy


• Positive attitude


• Flexible


• Team player

DESIRED JOB KNOWLEDGE AND SKILLS:

• Experience utilizing EPIC

• Knowledge of EOBs, CPT & ICD10 codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/referrals

WORK ENVIRONMENT:

• Physical demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. Specific vision abilities required by the job include close vision, distance vision, color vision peripheral vision, depth perception, and the ability to adjust focus.


• Work environment: The noise level in the work environment is usually high