Job Category:

Job Functions, Duties, Responsibilities and Position Qualifications:

Position Summary:

The purpose of the Customer Care Representative is to handle all inbound calls regarding patient and insurance billing inquiries in a production oriented, high volume call center. This position requires critical thinking and a demonstrated ability to handled callers professionally and competently. Other functions include analysis of insurance explanation of benefits (EOB) and claims research.

Duties & Responsibilities:

• Greet clients, patients, and insurance companies on the telephone in a friendly and courteous manner.
• Obtain appropriate patient information including account number, patient name, person calling, and their reason for calling.
• Make an attempt to assist with caller's situation while still on the line. If not possible, let them know you will get back with them in a timely fashion.
• Follow through with appropriate action (i.e.: refile claim, non-approval adj, send to review, etc.).
• Enter notes in account and fill out phone log sheet.
• Locate any paperwork that needs to be attached to refile (i.e.: an EOB lab results, copy of requisition, etc.).

Other Responsibilities:

• Process bankruptcy notices by documenting and adjusting the patient's account(s).
• Research for correct addresses for bad address (return mail).
• Review and process Financial Assistance applications.
• Monitor, review, and respond to any patient correspondence via e-mail, fax, or incoming mail.
• Outgoing collection calls as time permits.

Education and Experience:

• High School graduate or equivalent.
• Prefer at least two (2) years of experience in healthcare accounts receivable environment.
• Knowledge of medical terminology, billing and coding is preferred.
• Demonstrate proficiency in Microsoft Word and Excel.
• Adhere to Medicare, Medicaid Compliance and HIPAA guidelines in relation to PHI information.
• Excellent customer relation skills and phone technique.
• Work well independently and be self-motivated.
• Previous data entry and reading of insurance EOB's preferred.

Knowledge, Skills, and Abilities:

• Ability to communicate effectively, both orally and in writing.
• Ability to work independently, be attentive to detail, and provide quality work.
• Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
• Ability to establish and maintain positive relationships with employees, physicians, vendors, clients, and external agencies.
• Ability to demonstrate knowledge of medical terminology related to blood collection.
• Ability to operate medical tools and equipment in carrying out phlebotomy procedures.
• Ability to maintain the confidentiality of employee, patient, client, and company information at all times.
• Ability to demonstrate commitment to compliance with applicable laws: federal and state regulations, including CAP, CLIA, HIPAA, Safety, and OSHA Regulations.
• Proficient with Microsoft Office Suite or related software.

Scheduled Weekly Hours:

Work Shift:

Company:

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.