PFS Customer Service Rep 1

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.

CULTURE OF EXCELLENCE BEHAVIOR EXPECTATIONS

To perform the job successfully, an individual should demonstrate the following behavior expectations:

Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.

Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.

Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.

Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

EDUCATION & EXPERIENCE

High school diploma or equivalent preferred.

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

ADDITIONAL REQUIREMENTS

Passing the Driver's License Check and/or Credit Check (for those positions requiring).

Passing the WI Caregiver Background Check and/or IL Health Care Workers Background Check.

Must be able to follow written/oral instructions.

WORK ENVIRONMENT

The noise level in the work environment is usually quiet.

Occupational Exposure: Category C - No partners in the specified job classification have occupational exposure.

AGE OF PATIENTS SERVED

Adolescents (13 years - 17 years)

Adult (18 years - 64 years)

Geriatric (65 years and older)

INFORMATION ACCESS

Partner may access patient care information needed to perform their job duties.

WORK CONTACT GROUP

Partners, physicians, patients/family, visitors, vendors

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.

PAY RANGE:

Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.

Mercyhealth offers competitive pay and a comprehensive benefits package including:

• Medical, Dental, Vision

• Life & Disability Insurance

• FSA/HSA Options

• Generous, accruing paid time off

• Paid Parental and caregiver leave

• Career advancement and educational opportunities

• Tuition and certification reimbursement

• Certification Reimbursement

• Well-being Programs

• Employee Discounts

• On-Demand Pay

• Financial Education

• Annual recognition/awards events

• Partner appreciation days

• Family entertainment/attractions discount

• Community service/improvement opportunities

Click here for more details regarding Mercyhealth Careers Benefit Information.

At Mercyhealth, we don't simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.

Mercyhealth has been nationally recognized for our commitment to our people and culture, including:

• #1 in the nation on AARP's Best Employers for Workers Over 50

• One of Working Mother magazine's 100 Best Companies for Working Mothers

• A Top 50 Company and Top 10 Nonprofit for Executive Women