Senior Customer Services Representative – Financial Counseling & Revenue Cycle Support

Description

Reports To: Director of Revenue Cycle Management

Classification: Non-Exempt

Role Structure & Career Path:

This is a hybrid position within the Customer Services team that pairs full Customer services duties with a growing set of financial counseling and revenue cycle responsibilities. It is intended as a development pathway into the Revenue Cycle Management department as Summit’s volume and staffing needs increase.

• Current state: approximately 70–80% Customer services and 20–30% revenue cycle responsibilities.
• Future state: approximately 50% Customer services and 50% revenue cycle responsibilities.
• Long-term: transition into a full-time Revenue Cycle Specialist position as volume and staffing needs increase.

Position Summary:

The Senior Customer Services Representative serves as an advanced member of the Customer Services team with additional responsibilities supporting financial counseling and revenue cycle operations. This position performs all standard Customer service functions, including patient registration, scheduling, insurance verification, and customer service, while also assisting with patient financial counseling, collections, accounts receivable follow-up, and other revenue cycle initiatives. As organizational growth occurs, this role is expected to assume increasing responsibility within the Revenue Cycle Management department.

Essential Job Functions:

Customer Services Functions

• Answers incoming telephone calls, determines the nature of the call and refers the call to the appropriate person or appropriately documents the message with the appropriate communication device.
• Greets and registers patients arriving to the facility. 
• Provides callers with information such as company address, directions to the company location, company fax numbers, company website, and other related information.
• Verifies the completeness of patients’ initial encounter form, especially demographics, primary care physician and insurance information. Enters data into the computer(s).
• Accepts payments and prepares receipt for patient.
• Screens correspondence and distributes it to appropriate personnel.
• Performs scanning and data entry into the electronic medical record.
• Prepares reports as requested
• Establishes and maintains professional contacts 
• Always maintains patient and Company confidentiality
• Ability to troubleshoot/ problem solve issues
• Highly motivated and able to work independently
• Ability to multi-task

Financial Counseling & Revenue Cycle Functions

• Provides patient financial counseling, including reviewing estimated costs, out-of-pocket responsibilities, deductibles, coinsurance, and available payment options.
• Verifies insurance eligibility and benefits prior to service and communicates coverage details to patients.
• Assists with patient collections, including point-of-service collections and follow-up on outstanding balances.
• Supports accounts receivable follow-up, including reviewing claim status and helping resolve outstanding accounts.
• Assists with revenue cycle projects and initiatives as assigned.
• Serves as a resource to Customer Services team members on registration accuracy and patient financial questions.

Requirements

Working Conditions:

This position primarily works in an office environment, however has potential for varied environments including acute care facilities.  

Physical Requirements:

This position is primarily an office position requiring walking, bending, stooping, crawling, squatting and lifting up to 50 pounds. At times must lift up to 75 pounds. Potential for long periods of sitting, standing or viewing a computer screen. Additionally, repetitive movements are required. Must have visual acuity and manual dexterity to interface with the computer. Must have auditory acuity to effectively interact with patients and public.

Essential Qualifications:

• High School Diploma or GED
• 1 year of customer service experience
• Can interface with computers effectively
• Working knowledge of Microsoft Office programs: Excel, Word, PowerPoint and Outlook
• Learns new concepts and procedures quickly
• Excellent organizational skills
• Honesty
• Accuracy
• Ability to manage time and appropriately prioritize tasks and responsibilities
• Ability to communicate effectively with co-workers, vendors and other people in contact with in a professional and courteous manner
• Punctuality
• Flexibility and willingness to help cover other jobs when needed
• Ability to problem solve

Additional Qualifications – Financial Counseling & Revenue Cycle:

• Insurance verification experience
• Medical billing knowledge
• Patient collections experience
• Understanding of deductibles, coinsurance, and patient benefits
• Strong analytical and problem-solving skills
• Ability to communicate financial information to patients clearly and compassionately
• Interest in revenue cycle operations and career growth

Preferred Qualifications:

• Experience in a medical office and medical terminology are assets
• Experience with Electronic Medical Records Systems

The above statement statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.