Customer Service Representative - Professional Business Office

Position Objective:

PBO Customer Service Representative (PCS) is responsible for assisting customers resolve billing concerns and outstanding self-pay and bad debt balances for services billed by Luminis Health Professional Business Office.  PBO Customer Service Representatives explain insurance and self-pay liability and assist customers in finding solutions to pay their balances by: collecting money over the phone, establishing payment plans, acting as a liaison for accounts in bad debt and determining eligibility for state/local programs including Luminis Health medical financial assistance programs.   PBO Customer Service Representatives follow best practice collection techniques while providing the customer an exceptional customer service experience. Essential Job Duties:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

The PBO Customer Service Representative is responsible providing exceptional customer service to customers while resolving billing concerns and self-pay collections while adhering to compliance with policies and regulations.

Responsibilities:

1. Answer and document incoming customer calls, confer with outbound calls to ensure customer issues are fully resolved timely. Provide and document customer’s updates in progress to resolve concerns and realistic time frames to complete.
2. Explain questions related to billing, refunds, insurance plan adjudicated benefits, self-pay and bad debt balances.
3. Work as a liaison with internal billing units and bad debt vendors to resolve concerns, errors and/or recall bad debt placements. Update bankruptcy information, perform self-pay adjustments according to policy
4. Verifying and updating patient and guarantor demographic, health insurance coverage and account status information into the billing system.
5. Guide patients/guarantors in applying for Medical Financial Assistance. Determine eligibility for assistance, process application and update balance according to policy.
6. Assist patients with applying for state or federal medical financial assistance.   
7. Collect pre- service payment and self-pay balances and/or establish payment plan arrangements per policy.
8. Properly manage self-pay and bad debt collection work queues to reduce self-pay accounts receivable and avoid bad debt write off.
9. Update statement holds, monitor statement processing, demand print and mail statements or itemized bills on request.
10. Perform other duties as assigned.

Educational/Experience Requirements:

• High School Diploma or equivalent (GED) is required.
• Three years’ experience in the health care industry preferred.
• Knowledge of the principles of accounting and financial analysis.
• Working knowledge of full scope revenue cycle management process; from encounter/claim creation, follow up, guarantor statement cycle required.
• Experience working with EPIC modules highly preferred.
• Experience operating multi-line phone system, fax machines, photocopiers, PCs, and credit card machines.
• Must demonstrate a professional and courteous disposition and an ability to communicate well.
• Exceptional customer service skills required, prior customer service experience preferred.

Working Conditions, Equipment, Physical Demands:

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands –

Light Duty

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position.  This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.