Providence Health & Services Customer Service Specialist in Portland, Oregon
Providence is calling a Customer Service Specialist (1.0 FTE, Days) to the Providence Office Park in Portland, OR.
We are seeking a Customer Service Specialist who will be responsible for performing account resolution activities on accounts receivable for all PHS-Oregon facilities. The RBO is a fast paced work environment with complex operations spanning all hospitals, several clinics and multiple specialty lines of business in Oregon. Operations for the RBO include providing service for multiple entities (over 100 direct care departments), multiple types of services (over 100,000 chargemaster items) and multiple payment mechanisms (over 100 separate insurance contracts/payment mechanisms). Additionally, the RBO is a multi-computer system environment requiring the responsibility to work with multiple computer systems in serving the various customers.
The Customer Service Specialist I/Collection Specialist will perform customer service and collection activities for PHS Oregon hospital accounts. This role serves as the first level representative in handling account resolution. As requested, the Specialist also completes special assignments as needed. The Specialist I is required to balance quality and volume in providing excellent customer service to all incoming and outgoing calls directed to
In this position you will have the following responsibilities:
Split Skill Automatic Call Distribution (ACD) inquiries: Respond to patients, patient families, community resources, physicians, clinics, insurance companies, and other internal and external questions, concerns and needs. Resolve and document inquiries at point of service according to departmental guidelines and standards.
Analyze the various activities and interactions PHS-RBO has had with a patient and determine the most appropriate action or service to provide for the patient (i.e. customer service adjustments, etc.).
Ability to extract, review and interpret billing statements, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies) while resolving account balances.
Review, interpret and provide education regarding charges and billing information to patients or insurance companies. Escalate charge discrepancies as appropriate to RBO contacts for care department review.
Provide follow-up on internal and external customer calls in a timely manner to ensure comprehensive and complete service in meeting patient's needs.
Utilize solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc. according to both internal and Federal HIPAA regulations and guidelines.
Maintain high level of industry knowledge of insurance benefits and internal process flows and provide education to customers regarding insurance benefits, managed care contract discounts and payment systems (DRG, Flat Fee, Per Diem, Charge Based) to others.
Ability to capture and understand the key financial data regarding a given patient to determine the patient's general financial situation and ability to pay for balances due.
Negotiate payment arrangements and set up payment plans. Demonstrate sound decision-making regarding payment arrangements with patients. Demonstrates knowledge in payment systems such as Managed Care Contracts, DRG based systems, Per Diem rates, multiple insurance benefits with deductibles and co-payments.
Maintain knowledge of various community and PHS resources to offer a PHS-RBO customer/patient in resolving an account balance (i.e. federal programs, pharmacy program, etc.) Maintain current knowledge and basis understand of state or federal assistance programs.
Interview patients/guarantor to obtain necessary financial information in determining whether they would quality for financial assistance.
Perform telephone activities concurrent with computer activities up to 7 hours per day while in constant communication with others.
Achieve and maintain appropriate quality and productivity standards.
Collaborate with Quality Management and other teams/departments as appropriate to address and resolve customer concerns or complaints, and to follow up on requests for information or account/insurance follow-up.
Required qualifications in this position includes:
High school Diploma or equivalent
2 years experience in customer service
Preferred qualifications in this position includes:
Completion of a Providence Internship
2 years experience in customer service call center environment in health care -or- 2 years experience in full-time collections in health care
Experience in automated, computerized account follow-up system
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Patient Services
Req ID: 245423