PFS Customer Service Representative PBO

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The PFS Customer Service Rep role coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. We work as a team to ensure reimbursement for services in a timely and accurate manner.

• Minimum of 1 year experience in Customer Service and/or Call Center, clearly reflected in resume;
• Minimum of 1 year Healthcare experience in Finance, Revenue Cycle, or Patient Financial Services

POSITION SUMMARY
This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

CORE FUNCTIONS
1. Responds to incoming calls to provide assistance and excellent customer service to patients, patient families, providers, and other internal and external customers to resolve billing, payment and accounting issues

2. Responsible to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing and PCI compliance.

3. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.

4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.

5. As assigned, works with walk-in patient’s with accounts and processing payments.

6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.

7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.

8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences. Strong knowledge of insurance plans with deductibles and co-insurances.

Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

PREFERRED QUALIFICATIONS

Work experience with the Company’s systems and processes is preferred. Previous cash collections experience is preferred. Bi-lingual a plus.

Additional related education and/or experience preferred.

EEO/Disabled/Veterans

Our organization supports a drug-free work environment.

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