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Specialist-Customer Care II

at Baptist Memorial Health Care in Memphis, Tennessee, United States

Job Description

Job Responsibilities

Handles telephone communication with patients, insurance companies and other BMG/BMHCC personnel.

Bills, collects and submits all insurance and TPA claims according to payer guidelines, and established procedures and workflows.

Works all insurance denials, via paper and/or electronic in work queues with patient on phone.

Reviews accounts for possible assignment to BD.

Reviews and sets up payment plans as requested by patient.

Reviews and processes adjustments as needed to resolve credit balances and ensure account balances are correct.

Communicates with Insurance companies.

Reviews accounts for accuracy.

Reviews items directed to Customer Service through MyChart communications.

Reviews self-pay accounts forwarded to Customer Service by collection vendors.

Completes assigned goals

Job Summary

Responsible for daily customer inquiries from internal and external customers to completion. Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Responsible for follow up on Accounts Receivable to all payers. Serves as a resource for other Office staff and patients concerning expected payments, payments made and contract conflicts. Performs other duties as assigned.

Education

Description Minimum Required Preferred/Desired High School Dipolma or GED Ability to read, write and perform mathematical calculations, user of proper composition, grammar, oral communication and spelling as normally acquired by official completion of high school and/or its equivalent. Knowledge of general office techniques as normally acquired through two years of experience in credit and collections. Some College or Associate degree desired.

Experience

Description Minimum Required Preferred/Desired Business related clerical job skills including keyboarding. One year of insurance follow up or billing experience. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Possess the organizational skills to manage and prioritize a multi-task position. Possess interpersonal skills necessary to successfully interact with clients and Company staff. Must maintain telephone and personal etiquette to effectively deal with clients, vendors, peers and management even under stressful conditions. Preferred clerical skills with a working knowledge of accounting and insurance coverages and three (3) years’ experience in a physician’s office or hospital business setting. Good customer service skills are a requirement.

Licensure

Description Minimum Required Preferred/Desired

BOT Position Code #: 11823

Day Shift: Yes

Night Shift: No

Department Name: HS Customer Service

External Company Name: Baptist Memorial Health Care Corporation

External Company URL: http://www.baptistonline.org

Street: 965 Ridge Lake Blvd.

Overview and Responsibilities:

Job Responsibilities

Handles telephone communication with patients, insurance companies and other BMG/BMHCC personnel.

Bills, collects and submits all insurance and TPA claims according to payer guidelines, and established procedures and workflows.
Works all insurance denials, via paper and/or electronic in work queues with patient on phone.
Reviews accounts for possible assignment to BD.
Reviews and sets up payment plans as requested by patient.
Reviews and processes adjustments as needed to resolve credit balances and ensure account balances are correct.
Communicates with Insurance companies.
Reviews accounts for accuracy.
Reviews items directed to Customer Service through MyChart communications.
Reviews self-pay accounts forwarded to Customer Service by collection vendors.
Completes assigned goals

Job Summary

Responsible for daily customer inquiries from internal and external customers to completion. Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Responsible for follow up on Accounts Receivable to all payers. Serves as a resource for other Office staff and patients concerning expected payments, payments made and contract conflicts. Performs other duties as assigned.

Qualifications:

Education

Description Minimum Required Preferred/Desired High School Dipolma or GED Ability to read, write and perform mathematical calculations, user of proper composition, grammar, oral communication and spelling as normally acquired by official completion of high school and/or its equivalent. Knowledge of general office techniques as normally acquired through two years of experience in credit and collections. Some College or Associate degree desired.

Experience

Description Minimum Required Preferred/Desired Business related clerical job skills including keyboarding. One year of insurance follow up or billing experience. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Possess the organizational skills to manage and prioritize a multi-task position. Possess interpersonal skills necessary to successfully interact with clients and Company staff. Must maintain telephone and personal etiquette to effectively deal with clients, vendors, peers and management even under stressful conditions. Preferred clerical skills with a working knowledge of accounting and insurance coverages and three (3) years’ experience in a physician’s office or hospital business setting. Good customer service skills are a requirement.

Licensure

Description Minimum Required Preferred/Desired
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Job Posting: JC168546320

Posted On: Sep 19, 2020

Updated On: Nov 18, 2021