CALL CENTER CUSTOMER SERVICE REP - PATIENT FINANCIAL SERVICES

St. Luke's Hospital - Missouri - Chesterfield, MO (30+ days ago)3.3


Description
Processes patient accounts in accordance with the departmental and institutional policies and procedures. Obtains/reviews accurate demographic and insurance information and corrects information as needed. Processes accounts for accurate registration and payment. Obtains patients signatures and explains hospital financial documents to patients. ie: Authorization for Treatment/Terms of Treatment Agreement form, Advance Beneficiary Notice (ABN), Release of Medical Information, HIPAA Release of Information, etc. and scans them in to the STAR system via HBF and/or ILE. Collects copayments, estimated co-insurance and deductibles. Completes the Medicare Secondary Payer (MSP) questionnaire. Documents actions taken, answers inquiries involving individual accounts and researches problem accounts to assure payment. Maintains knowledge of financial computer system. Performs duties and responsibilities in a manner consistent with our mission and values. Assures integrity of critical system data elements. Completes assignments in the prescribed time periods with efficiency and attention to detail. Obtains demographic and insurance information in order to create a new patient account and/or correct incomplete/missing information on an existing patient account. Answers patient and/or third party inquiries into the status of account, coverage and insurance questions. Enters orders for tests/procedures in STAR as documented on the physician’s order and/or department schedule. Collects co-payments, estimated co-insurance/deductibles and balances from previous accounts. Screens for financial assistance and discusses payment options with patients. Accommodates requests from patients and physicians to the extent possible. Uses and demonstrates understanding of the patient accounting computer system, including system reports and security procedures. Adheres to Patient Financial Services/Patient Access and St. Luke’s Hospital’s policies, hospital/physician billing practices, third-party requirements and HIPAA regulations. Teaches new employees and other staff members procedures. Maintains good rapport with patients, physicians, third-party payors and other department representatives. Works efficiently with other staff members to accomplish work and department projects. May describe procedures to auditors or others from outside the department.

May review or initiate procedures and recommend changes. 60%

Interacts by telephone and/or in person with patients other departments, physician offices and reviewing agencies. Accurately and efficiently creates/processes the account including transaction records and other functions. Stays abreast of contract, regulation, procedure, and other changes affecting the department. 30%

Provides information and assistance to physicians regarding registration/billing procedures.

Reports unusual accounts, account problems, and workflow issues promptly to the Manager. 5%

Performs other duties as assigned. 5%

Total 100%

CSR II – will meet all the above accountabilities in addition to the CSRII qualifications as documented on the PFS Career Path Ladder (see attached). Employee will need to score 100% on each section of the test. If the employee does not score 100% in a particular section, the employee will be able to retest that section of the test after 60 days

Education
High school diploma or equivalent required.

Experience
35 WPM accurate typing skills. Proficiency with 10-key calculator and/or data entry skills required. One year related work experience preferred. Effective oral and written communication skills required. Computer experience preferred. Must be capable of maintaining a high degree of productivity with attention to detail and accuracy and ability to understand third-party requirements/regulations for effective job performance. Must be capable of accurately determining patient insurance information, data entry, and processing to meet the Hospital's financial objectives. Must be able to interact effectively with staff and patients and demonstrate positive customer relations while maintaining patient confidentiality.

Working Conditions
Employee is required to sit continuously and walk occasionally. Employee must lift/carry a light (1-20 lbs.) load frequently. Employee is frequently required to bend, squat, crawl, kneel, climb, lift waist to overhead. Employee is occasionally required to reach forward and reach overhead. For repetitive action, employee is required to use both hands for simple grasping and pushing/pulling. Employee is occasionally exposed to electrical hazards and CRT terminal work continuously.

(Occasionally: 1-33%, Frequently: 34-66%, Continuously: 67-100%)

The most significant of duties are included but this does not exclude occasional work assignments not mentioned or developmental duties.

Job Relationships:
Takes directions from: Manager – Patient Financial Services
Associate Director – Patient Financial Services
Director – Patient Financial Services

Mission/Values
Faithful to our Episcopal-Presbyterian heritage and its ministry of healing, St. Luke's is dedicated to improving the health of the community. Using talents and resources responsibly, our medical staff, employees and volunteers provide care for the whole person with compassion, professional excellence, and respect for each other and those we serve.

Core Values: Human Dignity, Compassion, Justice, Excellence, and Stewardship.

Human Dignity: We accept and treat all persons as being created in the image of God.

Compassion: We respond with caring to the needs of others as if they were members of our family.

Justice: We honor each person's rights and responsibilities in light of the common good.

Excellence: We set and strive to attain high standards of performance and continuous improvement.

Stewardship: We use our talents and resources wisely, with honesty and integrity.

FACES - Friendly - Available - Caring - Efficient - Safe

Communication Standards: Promotes and provides courteous and effective communication with internal and external customers.