Clinic Customer Service Rep

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Administrative/Clerical
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2020-R0279121 Requisition #
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JOB DESCRIPTION POSITION SUMMARY

This job is responsible for performing clinic customer service functions related to billing questions in accordance with applicable guidelines. An incumbent serves as a liaison between clinics and the Revenue Cycle team on questions regarding billing and reimbursement. In addition, an incumbent is responsible for answering questions posed by clinic staff according to proper billing guidelines and for providing feedback and training based on examples and/or trends identified in the Revenue Cycle.
Work requires attention to detail, the ability to accurately and timely troubleshoot/resolve questions/issues and to resolve (within scope of the position) issues which may have a potential impact on revenues.

ESSENTIAL JOB RESPONSIBILITIES


Receives and responds in a timely and professional manner to all billing-related questions posed by clinic staff; serves as liaison with various Revenue Cycle teams and other departments to respond to, or initiate response to, clinic questions.
Fields incoming call and email volumes from patients and Clinics in organized manner, addressing individual clinic concerns with attentiveness.
Explains various billing issues affecting reimbursement, including billing edits, reimbursement methodology, denial trends, and payer regulations or requirements to clinic representatives.
Provides feedback and training to clinic staff based on examples and/or trends identified in the Revenue Cycle, as necessary.
Applies knowledge of CMS and other insurance billing guidelines and regulations, payer contracts and reimbursement as well as experience with insurance review to gather additional information, as necessary.
Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority.
Collaborates with Patient Advocacy, Quality, and Risk departments as needed to resolve quality/risk adjustment requests from clinics.
Identifies trends in clinic questions and billing issues, and proactively resolves in accordance with established guidelines.
Notifies Supervisor/Manager of other ongoing issues and concerns.
Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation and written responses to clinic issues; maintains confidentiality of medical records.
Meets quality assurance and productivity standards for timely and accurate account resolution in accordance with organizational policies and procedures.

MINIMUM QUALIFICATIONS

Required Education and Licensure
High School Diploma or GED

Required Minimum Experience
Four years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities.
Two years customer service experience

Preferred Qualifications
Graduation from a post-high school program in medical billing or other business-related field is preferred

About Us


CHI Memorial is a not-for-profit, faith-based healthcare organization dedicated to the healing ministry of the Church. Founded by the Sisters of Charity of Nazareth and strengthened as part of Catholic Health Initiatives, it offers a continuum of care including preventative, primary and acute hospital care, as well as cancer and cardiac care, orthopedic and rehabilitation services. CHI Memorial is a regional referral center of choice with 3,400 associates and more than 700 affiliated physicians providing health care throughout Southeast Tennessee and North Georgia.

Equal Opportunity Employment


Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

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