University of Rochester Customer Resolution Specialist in Rochester, New York

Opening

Full Time 40 hours Grade 008 URMFG Business Office

Schedule

8:30 AM-5 PM

Responsibilities

Job Summary:

The Customer Resolution Specialist performs the functions of Patient Account Management for individuals receiving care from the University of Rochester Medical Center and Highland Hospital. The Customer Resolution Specialist responds to inquiries from patients and their advocates related to accounts within the billing systems (Flowcast and HBOC). The position requires a broad knowledge based about medical billing, rules and regulations of third party billing, and the complexities of professional and hospital billing. In addition, the position requires utilization of the billing systems to interpret and respond to inquiries and account resolution.

Responsibilities:

With general direction of the Customer Resolution Management Team and with latitude for initiative and judgment:

Incoming Patient Inquiries:

  • Receives incoming calls from both internal and external customers regarding billing issues, in a timely and customer friendly manner regarding outstanding balances as a result of statements sent.
  • Receives and processes mail correspondence from both internal and external customers regarding outstanding balances as a result of statements sent.
  • Performs review and research procedures on billing issues on unresolved patient accounts.
  • Verifies and updates demographic and insurance information.
  • Initiates insurance billing either electronically or via the use of the Electronic Work file transfer process within the billing systems for accounts classified as Self-Pay in error.
  • Identifies and verifies coverage under the government health insurance programs.
  • Creates budget installment payment plans for those callers in need.
  • Advises callers about insurance and payment options in order to secure revenue for URMC and HH.

Outgoing Patient Calls:

  • Initiates outgoing calls to customers regarding outstanding balances, in a timely and customer friendly manner.
  • Receives incoming calls regarding outstanding balances as a result of collection letters sent.
  • Performs review and researches procedures on billing issues on patient accounts.
  • Verifies and updates demographic and insurance information.
  • Initiates insurance billing either electronically or via the use of the Electronic work file transfer process within the Flowcast system for accounts classified as Self-Pay in error.
  • Identifies and verifies coverage under the government health insurance programs.
  • Creates budget installment payment plans for those callers in need.
  • Advises callers about insurance and payment options in order to secure revenue for URMC and HH.

Work File Maintenance:

  • Creates and follows ticklers on research issues.
  • Tracks and identifies trends with billing and provider issues.
  • Using best judgment under set procedures, alerts management regarding issues not completed within specified timeframes.

Performs other related duties as assigned.

Requirements:

High school graduate with 4 years’ experience in patient accounts related area or Bachelor’s degree with at least 1 year of related experience or equivalent combination of education and experience.

EOE Minorities/Females/Protected Veterans/Disabled

Job Title: Customer Resolution Specialist

Location: Medical Faculty Group

Job ID: 211369

Regular/Temporary: Regular

Full/Part Time: Full-Time