Specialist-Customer Care II Position Available In Shelby, Tennessee

Specialist-Customer Care II

Job ID:

30943

Job Category:

Administrative Non Clinical Support

Work Schedule:

Days

Department:

Customer Service

Facility:

BMHCC System Services

Location:

Memphis, TN
Overview
Job Summary
Responsible for daily customer inquiries from internal and external customers topletion. Responsible for the dailypletion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions topletion. 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.
Responsibilities
Handles telephonemunication with patients, insurancepanies 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 Insurancepanies.
Reviews accounts for accuracy.
Reviews items directed to Customer Service through MyChartmunications.
Reviews self-pay accounts forwarded to Customer Service by collection vendors.
Completes assigned goals
Specifications
Experience
Minimum Required
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 theanizational 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/Desired
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.
Education
Minimum Required
High School Dipolma or GED
Preferred/Desired
Ability to read, write and perform mathematical calculations, user of properposition, grammar, oralmunication and spelling as normally acquired by officialpletion 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.
Training
Minimum Required
PC skills and keyboarding and able to interact with others is required. Working knowledge of 10 key, typing andputers.
Preferred/Desired
Prefer knowledge of insurance billing and collections and insurance guidelines. Microsoft Office and Outlook with some medical terminology and customer service skills.
Special Skills
Minimum Required
Ability to type and/or key accurately, problem solving, written and oralmunication skills, financial counseling skills, knowledge of insurance billing (both hospital and professional settings) and collections, knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize andmunicate to clinical staff or designee when insurancepanies require additional review because of

NCCI, CCI

, LMRP, Mutually Exclusive and Medical Necessity edits. Effective Verbal, written and customer service skills as it relates to patients and insurancepanies. Able to createmunications to patients and insurancepanies as needed to resolve issues toplete billing/claim processes. Ability to work in a high stress environment. Ability to collaborate and cooperate with others for the best possible oues – promote Teamwork. Ability to prioritize and multi task.
Preferred/Desired
Knowledge of ICD-9, ICD-10, CPT and HCPCS codes and certification and/or degree in Healthcare Administration Business, Finance or related fields preferred.
Licensure
Minimum Required
Preferred/Desired