Customer Service Representative

Position Description: The Customer Service Specialist serves as Professional Physical Therapy’s primary contact for all patient billing inquiries. The Customer Service Specialist functions as a liaison between PPT and patients, providers and payers for all billing matters related to account resolution.

Pay: $22.95 - $24.77

Principal Duties and Responsibilities:

- Accepts all payments, makes outbound calls and accepts all inbound calls; ensures all calls are responded to from all parties (patients, clinics, insurance carriers, vendor) within a specific response-to-call timeframe and with the intent to resolve the caller’s concern.

- Assists patients in understanding billing statements to ensure swift resolution of outsizing balances.

- Makes necessary charge corrections to accounts to ensure patient ledger is an accurate reflection of the services provided.

- Utilizes all necessary tools and resources to resolve patient inquiries while on the phone or preparing/reviewing billing correspondence.

- Has an in depth understanding of different payer regulations/requirements and communicates effectively with patients regarding their Explanation of Benefits (EOB).

- Easily navigates Raintree and the Raintree ledger.

- Ensures all accounts are documented accurately.

- Follows scripts that are developed by the RCO management team to facilitate consistent and expedient account resolution.

- Reviews all returned mail, contacts patients to verify current address, updates demographic information in Raintree, follows process to send statement to current address.

- Responds to all patient calls to customer service regarding benefit questions, reviews Raintree TVBEN, utilizes insurance websites, and follows up with necessary department as needed.

- Completes written responses to patients and customers regarding account resolution and complaint recovery.

- Assists Customer Service team with patient balances and statement review.

- May assist with submitting authorizations and authorizations follow up.

- May assist with benefit verification, specifically during re-verification time.

- Works with insurance carriers for claims follow up and status of outstanding bills.

- Works with specific reports from Raintree and Yellowfin to ensure accuracy.

- Reviews collection files prior to patients being sent to collections.

- Provides support to staff for all functions of the RCO.

- Able to identify and rectify potential problems within specific projects.

- Behaves in a manner consistent with Professional’s mission, vision, and values.

- Maintains a working knowledge of HIPAA, OSHA, Risk Management, and compliance regulations.

- Attends Company meetings as required.

- Practices confidentiality in accordance with Company policies and all laws and regulations.

- Other duties as assigned by RCO Management.

Qualifications:

- Previous work experience (minimum three years) with healthcare customer service required.

- Bachelor’s degree preferred.

- Fully proficient in Raintree Navigation.

- Must demonstrate consistency in exceeding productivity goals.

- Strong organizational and time management skills are required.

- Establishes a collaborative environment capitalizing on employee talents, experience, interests, and diversity to reach high performance.

- Embraces diversity within the work environment and consistently deals with internal and external customers in a friendly and respectful manner; supports teamwork and cooperation with work partners in daily activities.

- Excellent analytical and problem-solving skills.

- Excellent communications skills are required.

- Ability to work independently and follow-through and handle multiple tasks and/or special projects simultaneously.

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