Job Description
WMCHealth
Montebello, New York, The Customer Service Associate is responsible for managing the day-to-day processes of the call center. This position documents and resolves patient concerns and inquiries for the hospital and associated physician bills. In addition, this position will work closely with the Directors of Patient Relations on the resolution of complex patient complaints involving quality of care issues. RESPONSIBILITIES:
* Follows up and resolves outstanding issues related to insurance questions/payments when requested.
* Coordinates with other departments when necessary in order to expedite the resolution of the patient’s issues in a timely manner.
* Notifies management of any escalating issues and potential trends in types of calls or customer complaints.
* Ensures all customer inquiries/complaints related to patient accounts are resolved in a timely manner.
* Arranges for Financial Assistance-Charity Care according to Federal and NYS regulations as necessary.
* Operates multiple patient information systems to resolve potentially complex accounts.
* Manages estate checks and deceased patient account resolution.
* Addresses inquiries from multiple sources including attorneys, insurance companies, patients and BSHSI Centers of Excellence.
* Retrieves and interprets payment documents from insurance companies and other sources.
* Ensures the appropriate revenue cycle flow is followed in order to optimize customer service and reduce patient liabilities.
* Ensures patients are aware of all financial assistance programs and coordinates with the appropriate vendor to make sure the patient receives the maximum level of assistance.
* Coordinates with the Billing Center of Excellence for situations that may require re-billing, additional reviews or edits to a claim.
* Offers patients monthly payment solutions when needed and facilitates the setup of Charity’s self-pay vendor.
* Follows all HIPAA (Health Insurance Portability and Accountability Act) rules and regulations.
* Performs other duties as assigned. QUALIFICATIONS / REQUIREMENTS: Experience: 3 to 5 years of experience in a hospital customer service, call center, billing or follow-up preferred. Education: High school diploma or equivalent preferred or meets experience requirements listed.
Licenses / Certifications: N/A Other: If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control. Bi-lingual Spanish speaking preferred. Must have a comprehensive understanding of insurance pre-certification requirements, contract benefits, credit/collection procedures, New York Charity Care & financial assistance programs, and medical terminology. Must have excellent communication, customer service, interpersonal and organizational skills About Us: Good Samaritan Hospital Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area’s leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children’s Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.
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