Allegheny Health Network
Job Description :
Responsible for researching and resolving complicated financial transactions and complicated Patient Accounts as referred by SBO Representative I, other staff and management from technical and professional billing systems. Serves as an escalated contact for patients with complicated and involved billing related issues. Analyzes billing issues ensuring contractual adjustments are correct and patient financial responsibility is properly stated on accounts. Follows department policies and procedures in resolving account balances. Works in a high volume call center environment and may be assigned to handling incoming and outbound calling as required. Displays exceptional verbal and written communication skills with a friendly customer service demeanor. Upholds the standards of the customer service program.
- Serves as escalated contact for AHN patients handling complicated accounts as referred by staff or management by: a) Greeting patients via telephone in a pleasant and professional manner, b) Prioritizing patient inquiries, c) Ensuring that accurate demographic and payer information is correctly reflected in the billing system, d) Discovering unbilled insurance and facilitate billing of claims, e) Identifying deductibles, out-of-pocket expenses; co-payments, percentage payables, preferred providers and other boundaries that are payer driven, f) Assisting with payment arrangements for patients according to AHN Payment Plan policy (65%)
- Posts appropriate adjustments to the accounts receivable systems. (5%)
- 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. (5%)
- Documents the accounts receivable system with all pertinent information regarding the patient interview, research performed, and resolution. (5%)
- Collects payments on account via telephone transaction with patient. (5%)
- 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. (5%)
- Researches and processes accounts subject to Bankruptcy regulations. (5%)
- Performs other duties as assigned or required. (5%)
- 3-5 years’ experience 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
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