Customer Service Rep - Flexible Schedule

Customer Service Rep - Flexible Schedule

Requisition Number: 4103
Job Title: Customer Service Rep - Flexible Schedule
Department: UUH ISC 34C HUMAN RESOURCES
Reg / Temp: Regular
Employment Type: Full Time
Shift: Days
Work Schedule: Days
Location: UNIVERSITY HOSPITAL - 50 NORTH MEDICAL DRIVE
City: SALT LAKE CITY
State: UTAH

Job Description:
: As a patient-focused organization, the University of Utah Health Sciences exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. The Health Sciences Center seeks faculty and staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission.

Position Summary:

This position reduces accounts receivable by following up on unpaid claims with third party payors, patients, or other responsible parties. Investigates assigned accounts to determine what additional steps must be taken for claims to be paid. The incumbent provides customer service by answering telephone calls and mail regarding patient account status, or meeting with patients and families to resolve billing issues.

Essential Functions:

- Contacts third party payors, patients, and other responsible parties to resolve unpaid claims. Follows and maintains accounts to ensure timely reimbursement and ensures follow-up dates are determined and tracked. Some positions may use a stratified work list to follow up on accounts.
- Researches and verifies accounts that are ready for collections.
- Resolves claim denials or underpayments by preparing appeals in accordance with payor guidelines.
- Responds to telephone calls and correspondence regarding account status, payment arrangements, and complaints or disputes.
- Resolves billing or charge disputes or forwards problem accounts to the appropriate individual for resolution.
- Documents actions and conversations in Allegra to provide status and next action steps for other representatives.
- Verifies that patient information, dates of services and coding are correct, and coordinates with Health Information Department to resolve coding discrepancies.
- Coordinates with clinical departments to resolve billing issues or obtain additional claim information.
- Informs patients or patient representatives of payment options and establishes payment plans.
- May process patient financial statements and review for charity.
- Assists in determining eligibility by contacting insurance carriers, including state assistance.
- Resolves credit balances.
- Determines or recommends charity or administrative write-offs.
- Coordinates benefits for third party liability.

Knowledge / Skills / Abilities:

- Ability to follow Hospital, insurance, and Medicare and Medicaid policies and procedures, and adhere to the Fair Debt Collection Practices Act.
- Ability to negotiate discounts with insurance companies and payment plans with patients.
- Knowledge on Health Care Financing Administration regulations
- Basic Knowledge on accounting principles
- Ability to assimilate data from various sources
- Ability to display active listening and verbalize empathy
- Ability to quickly learn new procedures and process
- Able to prioritize and multi task in a fast paced environment
- Have knowledge of HIPPA regulations to insure patient information is guarded and respected

Qualifications:
Required
- One year of experience of medical accounts receivable or insurance claims experience
- Current Procedural Terminology (CPT) and medical terminology

Preferred
- Two years of medical accounts receivable or insurance claim experience
- One year of call center experience