PFS Customer Service Rep 1

This role involves managing both inbound and outbound calls in a fast-paced call center environment. The customer service representative will interact with Mercyhealth's internal and external customers, including patients, guarantors, estate representatives, attorneys, clinicians, third-party payers, collection agencies, and Mercyhealth employees. They will address inquiries about medical accounts and work towards resolving outstanding balances promptly, aiming to collect patient balances before referring them to an external agency. The representative will be knowledgeable about all revenue cycle processes, from registration to billing and collections. Additionally, they will assist patients and their families with financial assistance applications and provide information on various resources for obtaining healthcare coverage.

Essential Duties and Responsibilities

• • In-depth knowledge of all applications used by Patient Financial Service partners such as: Epic, Retired Epic, Matrix, Kronos, Microsoft Outlook, Microsoft Excel, Microsoft Word, Cisco Finesse Agent Desktop, Passport OneSource, Paytrace, Forward Health, etc.

  • Fluent and knowledgeable on EPIC Guarantor based billing.

  • Take customer calls in a fast-paced environment with the ability to think quickly and provide accurate answers to their inquiries and concerns.

  • De-escalate situations involving dissatisfied customers offering assistance and support.

  • Assist walk-in patients with billing inquiries.

  • Guide callers through troubleshooting MyChart including generating activation codes and password reset of Guest pay accounts.

  • Work closely with pre-collect and bad-debt vendors to resolve patient inquiries in an efficient and accurate manner.

  • Researches and performs audits on patient accounts to determine where balances are due, from third party payers or patient responsibility.

  • Understand statement cycles, the bad-debt process and collection practices.

  • Has in-depth knowledge of community-based, state or federal government programs to provide assistance to patients who have no ability to pay for their health care needs. Screens patients and provides assistance with completion of the application process for the financial assistance program.

  • Thorough understanding of how to identify if charges on a patient's account are correct. The representative will need an in-depth understanding of what information is available to assist in the process of account resolution such as medical record, insurance websites, etc.

  • Assists patients/callers on billing concerns, account balances, account payment options and various insurance resources in person or over the telephone.

  • Complete pricing transparencies and estimates in person or over the telephone.

  • Responds to patient inquiries via in person, mail, phone, MyChart correspondence and/or email. Initiates follow-up to the appropriate Billing or Coding Department and insurance carriers to ensure payment for services.

  • Familiarity with rules and regulations for Government Insurance including Medicare and Medicaid, Commercial Payers, Third Party Liability, Worker Compensation, Institutional Accounts, Self-Pay, and third party collectors.

  • Responds to third party and patient requests on credit balances and initiates the refund process in the event monies are due back to the payer or patient.

  • Documents all patient encounters on appropriate patient account/claim utilizing notes. Ensures account is updated to accurately reflect the current status.

  • Serves as a liaison to all patient financial staff by maintaining good communication regarding any problems and/or resolutions to patient issues.

  • Assists with new-hire training to successfully meet 90-day standards.

  • Protects privacy and confidentiality of customers, patients and partners in accordance with Mercyhealth policies, the Code of Ethics and HIPAA laws.

  • Complies with Mercyhealth Cash Handling and Collection Policy.

  • Monitors ACD system on an as needed basis to ensure calls are answered timely.

  • Ability to meet or exceed established call center productivity metrics.

  • Ability to meet or exceed established goals on all call monitoring audits.

  • Ensures accurate and timely completion of daily tasks and projects.

  • Must be multi-task oriented with solid critical thinking skills and possess the ability to appropriately handle complexity and stress within the changing needs of the patients, families and health system.

Education and Experience

High school diploma or equivalent required.

2 - 3 years customer service experience preferred or 1 year customer service in medical field preferred

Special Physical Demands

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand; walk; climb; or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to:

* Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.

* Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.

* Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.

* Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.

* Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.

* Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.