Sr. Customer Service Representative - Revenue Cycle - Katy, TX

At Houston Methodist, the Senior Single Billing Office (SBO) Customer Service Representative position is responsible for acting as a liaison between Houston Methodist, patients, providers, and payers for all post-care matters related to account resolution. This position interacts with all SBO sub-units and other hospital and Physician Organization service areas on a daily basis, cultivating good business relationships to promote harmony and effective communication to resolve patient concerns post care. The Senior SBO Customer Service Representative handles more complex inquiries and assists management with identifying trends impacting performance and notifications of opportunities while providing innovative suggestions for process improvement. This position also assists management with auditing/quality review to ensure accurate and appropriate billing and account resolution. Other duties include serving as a resource, trainer, and mentor to other team members.

FLSA STATUS
Non-exempt

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

EXPERIENCE

• Three years of previous call center and hospital revenue cycle experience

LICENSES AND CERTIFICATIONS
Required
SKILLS AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Working knowledge of the patient billing cycle for both hospital and professional billing
• Excellent customer service and professional communication skills with the ability to remain calm in stressful situations
• Knowledge of medical terminology and applicability
• Excellent spelling/grammar skills
• Managed care knowledge with the ability to differentiate between insurance plans such as Preferred Provider Organization (PPO), Point of Service (POS), Health Maintenance Organization (HMO), etc.
• Ability to multi-task and flexibility to meet the requirements of the department and the organization
• Ability to problem solve in the moment and provide recommendations in alignment with values
• Proficient computer skills and ability to learn and navigate multiple software programs
• Strong training, leadership and mentoring skills
• Bilingual skills preferred

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal department and organizational results.
• Follows the standard talking points outlined in department protocols when interacting with patients to ensure high quality and consistent service.
• Serves as a resource and trainer for less experienced and new staff; orients, guides and mentors team members to help build confidence and competency in skills, knowledge and abilities.

SERVICE ESSENTIAL FUNCTIONS

• Provides follow-up for issues that are not solved on the initial inquiry.
• Receives and responds to more complex incoming inquiries via phone, email, patient portal, etc. in a timely fashion. Utilizes clear, concise, and professional communication skills both verbally and written.
• Leverages knowledge of external vendor workflow processes and information systems that promote the patient experience to resolve customer concerns more efficiently.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Utilizes sound judgment and analytical skills to bring the account for resolution, analyzing the data elements (clinical and financial) within the electronic health record to determine the current state of the account.
• Provides clear and concise documentation of every action taken on an account in the system collection notes. Provides balance breakdown to document the status of next responsible party (i.e., primary, secondary payor, patient balance, or credit balance).
• Meets or exceeds stated Performance Indicator Expectations (e.g., productivity, quality review, abandonment rate, adherence expectations).
• Consistently takes the necessary steps to ensure that protected health information remains private and confidential, according to established Health Insurance Portability and Accountability Act (HIPAA) guidelines.
• Identifies trends impacting performance and notifies supervisor/manager of opportunities for improvement.

FINANCE ESSENTIAL FUNCTIONS

• Follows levels of authority for posting adjustments, refunds, and contractual allowances.
• Uses resources effectively and efficiently. Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• engages in personal assessment and expands learning beyond baseline competencies with a focus on continual development (i.e., participates in training opportunities, focal point review activity, etc.). Applies new learning.
• Generates and communicates new ideas and suggestions that will improve quality or service. Demonstrates adaptability and flexibility in the face of changing demands.

SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): Yes

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area No

QUALIFICATIONS

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

EXPERIENCE

• Three years of previous call center and hospital revenue cycle experience

LICENSES AND CERTIFICATIONS
Required