Customer Service Representative

VISION, MISSION, PLEDGE & VALUES:

Every employee of SIHF Healthcare is expected to uphold our vision, mission, and values. Our actions will reflect our values of Compassion, Diversity/Inclusivity, Excellence, Integrity, Respect and Stewardship creating a culture in which all individuals are treated with dignity and respect. This will result in our vision of an “Enriched health and life in a just society” through the fulfillment of our mission to build partnerships, develop safe and affordable housing, community engagement in building trust and solutions, foster economic development, provide access to comprehensive health care services, and reduce disparities

CUSTOMER SERVICE COMPLIANCE STATEMENT:

Treat every person with dignity, respect and kindness by listening with your full attention, address questions/concerns immediately, and accept responsibility to follow through by always doing what you say you will do. You support our customers, and your team, by being patient, understanding and being positive, knowing that you are SIHF Healthcare to those we serve.

POSITION DESCRIPTION:

Responsible for ensuring team performance that supports the mission of SIHF Healthcare and facilitates the achievement of health center or department goals and objectives. Administer the functions within the department including but not limited to answering phone calls, responding to written correspondence, routing documents to appropriate personnel, posting payments received in office and over the phone and assisting site staff with system functions.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Answer telephone inquiries from patients, clients, employees and track external calls using an excel spreadsheet.
2. Resolve all patient questions or concerns in relation to billing inquires, insurance processing and posting, and any other questions related to information accessible within SIHF HealthCare’s EMR system.
3. Interact with billing staff and CBO Leadership Team to resolve customer concerns.
4. File manual documents for the RCM team.
5. Print itemized bills requested by patients and attorneys.
6. Verify eligibility information for all insurance presented by patients on the phone and bill accordingly.
7. Distribute interoffice mail and faxes to team members for processing. Fax correspondence to Athena.
8. Set a good and positive example for team members in professionalism, customer service, and adherence to SIHF Healthcare policies and procedures.
9. Provide excellent customer service to patients and clients daily.
10. Perform routine duties with minimal supervision.
11. Other duties as assigned.

KNOWLEDGE, SKILLS, ABILITIES:

1. Must be able to accurately read and interpret a health insurance explanation of benefits and interpret patient eligibility within SIHF’s EMR system, as well as on health insurance websites.
2. Must have well developed oral and written communication skills. Must have the ability to read and comprehend simple instructions, write correspondence, update and note patient accounts, and send clear communication to team member of SIHF healthcare and any outside agency as requested.
3. Ability to effectively present information in small groups and one-on-one situations to customers, clients, and/or other employees of the organization.
4. Proficient personal computer skills including electronic mail, record keeping, routine database activity, word processing, spreadsheet, graphics, etc.
5. Ability to prioritize assignment of multiple tasks.
6. Must be HIPAA compliant and maintain confidentiality of all health records.
7. Basic knowledge of Medicaid, Medicare and commercial insurance billing guidelines.
8. Ability to interpret insurance processing and posted items in an Electronic Medical Records (EMR).

EDUCATION AND EXPERIENCE:

1. High school diploma or GED and one-year related experience preferred.
2. An understanding of billing rules and regulation related to Medicaid, Medicare, private insurance and self-pay physician services is desired.

PHYSICAL DEMANDS:

Sedentary physical activity performing non-strenuous daily activities of an administrative nature

WORK SCHEDULE:

Normal work hours for this position are Monday through Friday dayshift. Occasionally, weekends and/or overtime is required.

COMPLIANCE STATEMENT:

Abide by the requirements all applicable State and Federal laws.

MEDICAL HOME STATEMENT:

Be aware and understand expectations and responsibilities of the Patient Centered Medical Home. Understand role, complete relevant duties, and the requirement to maintain highest level of proficiency within scope, as part of this team-based approach in the patient care continuum.