Customer Service Representative I
Job Ref # 32735
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Location: Houston, TX
Category: Professional
Job Type: Full-Time

Work Shift: DAY

Work Week: M - F


Job Summary

The Customer Service Representative I (CSRI) is responsible for acting as a liaison between the Hospital and the Physician Organization (PO) within Houston Methodist, the patient, providers, and payers for all post-care matters related to account resolution.

The CSRI will interact with all the Single Billing Office (SBO) sub-units and other hospital and PO service areas on a daily basis. The CSRI will need to cultivate good business relationships to promote harmony and effective communication to resolve patient concerns post care.

ICARE VALUES

System and department specific ICARE values

 

INTEGRITY: We are honest and ethical in all we say and do.

COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.

ACCOUNTABILITY: We hold ourselves accountable for all our actions.

RESPECT: We treat every individual as a person of worth, dignity, and value.

EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

 

JOB RESPONSIBILITIES

 

Duties and Responsibilities are cross-referenced to the hospital’s Pillars of Excellence and will be transferred to the Performance Evaluation.

People 20%

  • Accepts incoming phone calls to resolve the patient’s concerns or questions immediately
  • Communicates with other Hospital and PO Departments to ensure issue resolution for inbound callers
  • Provides follow-up for issues that are not solved on the incoming phone call
  • Identifies trends impacting performance and facilitate cross-training between unit staff
  • Demonstrates analytical skills required to bring the account for resolution. This includes analyzing the data elements (clinical and financial) within Epic® to determine the current state of the account. Also, the account memos are to be read with intent to understand prior actions taken on the account and to ascertain the next best action to take the account to resolution status.
  • Documents accounts in a brief and concise manner, indicating resolution or steps needed for resolution. Documented memos should be fully understood by the next person who reviews the account.
  • Attends regular unit meetings
  • Utilizes SBO technology in an effective manner to ensure resolution of customer concerns.

Finance 20%

  • Follows levels of authority for posting adjustments, refunds, and contractual allowances
  • Understands the Revenue Cycle and the patient account cycle in Epic to resolve calls efficiently

Quality/Safety 20%

  • Leverages knowledge of vendor and technology systems that promote the patient experience to resolve customer concerns more efficiently. Vendor and technology systems include but are not limited to: Epic®, Cisco ®, Emdeon ®, MyChart ® early out vendors, and bad debt vendors.
  • Leverages knowledge of payor systems to resolve customer concerns more efficiently by being able to communicate all the financials elements of the Explanation of Benefits to the customer. Payor systems include but are not limited to: Managed Care, Medicare, Medicaid, and Indemnity.
  • Follows the inbound scripting guidelines outlined by the Supervisor and/or Manager when interacting with patients to maintain a high quality of service
  • Meets weekly productivity and quality standards
  • Ensures protection of private health and personal information. Adheres to all HIPAA and PCI compliance regulations.
  • Participates in compliance discussions as required by the organization

Service 20%

  • Documents accounts in a brief and concise manner, indicating resolution or steps needed for resolution. Documented memos should be fully understood by the next person who reviews the account.
  • Demonstrates communication skills in a clear, concise, articulated and professional manner in both verbal and written capacities.
  • Demonstrates advanced knowledge of the cycle of a patient guarantor account, which will include hospital and physician charges

Growth/Innovation 20%

  • Attends required training sessions and execute skills acquired through training in a proficient manner as evidenced through quality review scores.
  • Work effectively to ensure resolution of customer concerns. This includes incorporating feedback and instruction/training into daily routines on an immediate basis.

EDUCATION REQUIREMENTS

High school diploma required; college degree preferred

EXPERIENCE REQUIREMENTS

1 year Hospital Information System experience and 1 year of previous customer service experience required.

Prior experience is Patient Access Service and/or Patient Accounting, etc. is preferred

 

CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED

None

SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

 

  • Advanced customer service and analytical skills preferred
  • Advanced PC skills; specifically proficient with Microsoft Office Suite
  • Advanced verbal and written communication skills in the English language

Equal Employment Opportunity

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of  race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law.

VEVRAA Federal Contractor – priority referral Protected Veterans requested.



Company Profile

Houston Methodist (HM) is one of the nation’s leading health systems and academic medical centers.  HM consists of 7 hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center and six community hospitals throughout the greater Houston metropolitan area.  HM also includes a research institute, a global business division, numerous physician practices and several free standing emergency rooms and outpatient facilities.  Overall, HM employs over 20,000 employees.   FORBES magazine has placed Houston Methodist on its annual list of Best Employers in 2016.  Houston Methodist is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide the best patient care and service in a spiritual environment.

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