Job Description

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.

Requirements

· 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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