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Customer Service Specialist

Kentucky Medical Services Foundation

This is a Full-time position in Lexington, KY posted November 28, 2021.

Job Title: Customer Service Specialist
Job Status: Non-exempt, Full time
Department: Patient Services
Reports to: Supervisor
Direct Reports: None
This position is a remote position; however, the incumbent must live and perform work within the state of Kentucky.

Certain internet requirements must be met.
In accordance with medical evidence and federal rules, UK HealthCare/KMSF requires COVID vaccination for all employees with appropriate exemptions for medical and/or religious reasons.

UK HealthCare requires new hires prior to their first day of employment, to submit appropriate documentation showing i) completion of the full vaccination series against COVID-19 (i.e., two weeks past completing their complete COVID-19 vaccination series), or ii) an approved exemption (medical contraindications or a sincerely held religious belief) through the formal vaccine exemption process.
Summary: This position exists primarily to provide knowledge, expertise, and assistance to customers whose problems and needs are beyond that of the Customer Services Representatives, and to see problems resolved in an effective and efficient way that instills or restores customer satisfaction and confidence, as well as departmental and organizational credibility.

Reviewing of accounts to increase the integrity of the data being sent to outside collections.

It also serves in an aid and assist role for any and every Patient Services sub-group, as needed; e.g.

Customer Service, Patient Collections, etc.

Questions directed to this position are related to both provider and hospital billing.
Essential Functions:

Fields customer calls, inquiries, and issues requiring a greater degree of knowledge or expertise, including calls escalated from any of the Patient Services Department

Fulfills potentially any or all of the following functions, when needed:

Provide itemized statements, including certified, to appropriate entities as requested

Handle Risk Management accounts

Assist in training of new employees

Handle patients referred by Office of Service Excellence

Assist with walk-in patients

Handle HIPAA and Guarantor related issues
g .Submit appropriate accounts to the Accounts Review Committee
h .Handle VIP groups/individuals

Produce daily/weekly report for questions received by Patient Service Staff

Review and handle incoming emails received by management, Patient Services Request email box and outside sources.

Handle bankruptcy accounts

Handle deceased accounts

Assist with Call Center as needed to take calls

Assist with Patient Services Staff questions

Produce daily report for Diamond and HDX statements

Works with Finance/Cash Department to correct posting Errors

Sends letters to patients regarding coding review

Fulfill special projects as assigned

Reports trends and training issues to Patient Services Management
3.Reviews incoming mail to determine where it need to be assigned
4.Assists in Collection area
a.Reviewing accounts to increase the integrity of data being sent to outside collections
b.Handling bad debt reports and working with patients in bad debt
c.Eligibility reports
5.Assists with working worklists and EBEWs and PAITEWL
6.Assists with Guarantor and Self Pay A/R review
7.Handles following duties as necessary:
a.Special billing or handling-Allergy, Alliance Coal, Shriners, etc.

Management may assign or reassign duties or responsibilities to this job at anytime, whether due to reasonable accommodation or for other reasons of business necessity or job improvement.

Education: High school diploma or equivalent required
Experience: Minimum of three to five years’ experience in physician or hospital billing environment or a minimum of six months proven performance in KMSF customer service department.
Work Environment: Work is performed in a temperature controlled, well-lighted office environment
Equipment Operated: Standard office equipment including computer, monitor, mouse, keyboard, fax machine, copier, printer, telephone, etc.
Physical Requirements: Job entails sitting approximately 90 percent of the day, walking or standing the remainder.

Job does not involve lifting or carrying objects of more than 10 pounds, climbing, crawling, kneeling, squatting, bending, stooping, or any other physically strenuous motions or activities.
Mental Requirements: Concentration, comprehension, focus and attention to details
System Responsibilities: In order to perform required job functions, this role is responsible for maintaining advanced skill levels in the following systems:

Soarian Financials
Proficient skill levels must also be maintained in the following systems:

Document Imaging systems
Encoder PRO
Share Point
Knowledge, Skills & Abilities:
1.Knowledge of insurance industry and billing procedures including patient responsibility guidelines
2.Knowledge of Fair Debt Collection Practices Act
3.Sufficient knowledge of policies and procedures to accurately answer questions from internal and external customers
4.Broad-based knowledge of relevant insurance regulations and familiarity with the Health Insurance Portability and Accountability Act
5.Knowledge of counseling, conflict resolution, and customer service principles and applications
6.Skill in proficient use of MS Outlook, Excel, and Word
7.Skill in serving as a resource to management
8.Skill in trouble-shooting problems
9.Skill in written and verbal communication and customer relations
10.Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public
11.Ability to respond to patients on credit matter in a courteous fashion
12.Ability to determine scope of problem and relay to management
13.Ability to set priorities
14.Ability to communicate clearly and effectively
15.Prevent, calm, or defuse irate patients
16.Ability to read, understand, and follow oral and written instructions
17.Commitment to company and department values (e.g.

integrity, accountability, collegiality, excellence, innovation)

Job Type: Full-time