Major Responsibilities:

Develops proficiency to answer customer inbound billing calls in a high-volume call center environment to service and retain customers. Responds to customers questions with the ability to resolve and process most concerns on the initial call.Learns to act using appropriate discretion, to address customer needs, resolve issues, and provide outstanding customer service. Works with appropriate departments to resolve questions and or issues related to billing, coding, and denials. Educates the customer regarding account concerns.Develops skills to access, understand and explain necessary information from the electronic patient billing and medical records system including claims inquiry, account history, and account status for both hospital and physician billing.Becomes skilled at investigating and responding to all phone and/or written inquiries from patients/guarantors, insurance companies, physician offices, and government agencies regarding medical account billing. Makes calls to outside sources for additional information to ensure that all inquiries are resolved. Shares information following HIPAA guidelines.Accurately documents and updates the patient account system with all information received and action taken. Makes changes to patient demographics and insurance information; submits or resubmits claims to the insurance company when appropriate.Keeps abreast of insurance sequencing rules, medical billing guidelines or laws, and changes impacting patient accounts and uses resources to validate correct process and explanation.Requests payment in full and processes payments using the online system. Establishes acceptable payment plans when payment in full cannot be made.Makes appropriate patient account adjustments as necessary.Develops proficiency to respond to complaints and resolve problems using established service recovery guidelines. Handles all escalated calls, attempting to resolve issues before they become escalated complaints. Works with appropriate departments to resolve questions and/or issues related to billing, coding and denials.Gathers and documents information and troubleshoots customer inquiries and issues by recognizing trends and reporting to higher level as needed.Proactively follows up with customers about information as needed to answer inquiries and resolve issues.

Education/Experience Required:

Education Required: High School Diploma or GED required. Experience Required: Typically requires 1 year of experience in medical billing, cash application or insurance follow up, including six months of call center experience.

Knowledge, Skills & Abilities Required:

Knowledge, Skills & Abilities Required: Demonstrated knowledge of the health care, insurance terminology, and medical billing. Ability to interpret an explanation of benefits and understand the system adjudication process and determine how a claim was paid. Ability to work in a high-volume call center environment, using a computer and the telephone the majority of the day. Excellent customer service and follow up skills. Ability to speak English with customers to resolve customer issues, along with research and document the call on a computer. The skill to speak other languages is a plus. Works with a variety of customers and actively listens and responds with empathy to build rapport and understanding. Proficient computer skills (mail, email, and fax) including patient accounting systems. Navigates within multiple systems and computer screens. Ability to perform basic math skills. Demonstrated ability to work well independently and as a team. Ability to follow and prioritize responsibilities Strong multi-tasking, organizational, and time management skills. Adapts well to change. Ability to handle all escalated calls and resolve issues before they become escalated complaints. Ability to represent AdvocateAuroraHealth and the company values to patients. Ability to work to balance all aspects of the call center’s KPI’s including Quality, Attendance, Adherence, Call productivity, etc. Demonstrates the Advocate Aurora Health purpose, values and behaviors.Licensure, Registration and/or Certification Required: None Required.

Physicial Requirements and Working Conditions:

Physical Requirements and Working Conditions: Exposed to an open call center office environment. Must be able to sit most of the workday. Operates all equipment necessary to perform the job. Open to working remotely from your home if required. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.