Company :Allegheny Health Network
Job Description :
Responsible for the financial resolution of all self-pay account balances from technical and professional billing systems. Follows department policies and procedures in resolving account balances. Serves as preliminary contact for patients who contact the Single Billing Office with inquiries regarding AHN patient statement balances, and resolves any billing related issues while ensuring patient satisfaction. Discovers and initiates rebilling of insurance claims. Assists patients with applying for Charity Care. Works in a high volume call center environment. Displays exceptional verbal and written communication skills with a friendly customer service demeanor. Upholds the standards of the customer service program.
- Serves as preliminary contact for AHN patients by:
- Greeting patients via telephone in a pleasant and professional manner
- Prioritizing patient inquiries
- Ensuring that accurate demographic and payor information is correctly reflected in the billing system
- Discovering unbilled insurance and facilitate billing of claims
- Identifying deductibles, out-of-pocket expenses; co-payments, percentage payables, preferred providers and other boundaries that are payor driven
- Assisting with payment arrangements for patients according to AHN Payment Plan policy
- Screening for patient eligibility for financial assistance per the AHN policy
- Maintaining positive customer service attitude when dealing with the public and AHN personnel
- Working effectively as a team member by offering support and/or ideas to enable the group to reach group goals
- Posts appropriate adjustments to the accounts receivable systems.
- Reviews and edits accounts from various work lists for such actions as third-party rebilling, adjustment posting, collection agency referral, or other options to appropriately resolve account balance.
- Documents the accounts receivable system with all pertinent information regarding the patient interview, research performed, and resolution.
- Collects payments on account via telephone transaction with patient.
- Responds to patient inquiries/concerns received by telephone or mail. Clarifies understanding of the inquiry/concern, determines the appropriate course of action, initiates and/or completes appropriate action, resolves Patient Complaints and does appropriate customer service recovery when required.
- Researches and processes accounts subject to Bankruptcy regulations.
- May be assigned to Customer Service In-Bound, Collection In-Bound, Collection Out-bound call centers as workload, and SBO management needs dictate.
- Performs other duties as assigned or required.
- Proficiency with a ten-key calculator and PC keyboard, familiar with Microsoft Word and Excel.
- Strong verbal and written skills.
- Strong Customer Service and service recovery skills working in a high volume call center environment.
- 2 years in a collection or a customer service oriented role
- Associate's degree in Business Management or Accounting
- Previous experience in a physician billing or health care claims environment (computerized billing)
- Previous experience in interviewing patients and family members
- Previous experience in working in a high volume collection or customer service call center environment
- Previous experience working in a predictive dialer environment
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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