Providence Health & Services Customer Service Specialist in Portland, Oregon
Providence St Joseph Health is calling a Customer Service Specialist (1.0 FTE, Day Shift) to Providence Portland Office Park in Portland, OR.
We are seeking a Customer Services Specialist to perform account resolution activities on accounts receivable for all PHS-Oregon facilities. The RBO is a fast paced work environment with complex operations spanning all hospitals, several clinics and multiple specialty lines of business in Oregon. Operations for the RBO include providing service for multiple entities (over 100 direct care departments), multiple types of services (over 100,000 chargemaster items) and multiple payment mechanisms (over 100 separate insurance contracts/payment mechanisms). Additionally, the RBO is a multi-computer system environment requiring the responsibility to work with multiple computer systems in serving the various customers.
In this position you will:
Split Skill Automatic Call Distribution (ACD) inquiries: Respond to patients, patient families, community resources, physicians, clinics, insurance companies, and other internal and external questions, concerns and needs. Resolve and document inquiries at point of service according to departmental guidelines and standards.
Analyze the various activities and interactions PHS-RBO has had with a patient and determine the most appropriate action or service to provide for the patient (i.e. customer service adjustments, etc.)
Ability to extract, review and interpret billing statements, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies) while resolving account balances.
Review, interpret and provide education regarding charges and billing information to patients or insurance companies. Escalate charge discrepancies as appropriate to RBO contacts for care department review.
Provide follow-up on internal and external customer calls in a timely manner to ensure comprehensive and complete service in meeting patient’s needs.
Utilize solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc. according to both internal and Federal HIPAA regulations and guidelines
Required qualifications for this position include:
High School diploma or GED equivalent, college coursework preferred.
Minimum 2 years experience in customer service (health care preferred).
Demonstrates outstanding public relations and interpersonal skills, both verbal and written
Excellent customer service skills and awareness
Demonstrates ability to deliver clear, correct, and timely communications and effectively work with both internal and external customers
Ability to quickly extract, review and interpret information from multiple computer system systems while resolving account balances
Ability to capture and understand the key financial data regarding a given patient to determine the patient’s general financial situation and ability to pay for balances due.
Demonstrates sound decision-making regarding payment arrangements with patients.
Demonstrates knowledge in payment systems such as Managed Care Contracts, DRG based systems, Per Diem rates, multiple insurance benefits with deductibles and co-payments
Basic data entry skills, ten-key and PC processing with ability to type a minimum 40 WPM with accuracy.
Ability to perform telephone activities concurrent with computer activities up to 7 hours per day.
Ability to multi-task, remain calm in stressful situations and to make quick and appropriate judgments to address various situations
Demonstrates knowledge of various community and PHS resources to offer a PHS-RBO customer/patient in resolving an account balance (i.e.: federal programs, pharmacy program, etc.)
Self-starter and team-oriented, flexibility to adapt to constant change, ability to work with little supervision
Demonstrated problem solving and decision making skills
Preferred qualifications for this position include:
2 years experience in customer service call center environment (health care preferred), or 2 years experience in full-time collections (health care preferred).
2 years experience in automated, computerized account follow-up system
knowledge in reimbursement of health care accounts from insurance companies.
Familiarity with basic medical and health plan terminology, CPT codes, ICD-9 coding
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Administrative Support
Req ID: 210898