Customer Service Representative - Healthcare RCM | Start ASAP

AGS Health Philippines, Inc; Taguig; On-site; PHP 300,000 - 420,000; Full time

Job summary

AGS Health Philippines, Inc. is seeking a Process Associate - CSR to handle patient inbound calls on billing matters onsite in McKinley, Taguig. You will resolve issues, verify insurance data, and coordinate with AR and collection agencies to ensure accurate balances and compliant processing.

Responsibilities include managing payment plans, processing payments over the phone, and adhering to HIPAA and PCI DSS standards, with a focus on accurate documentation.

Qualifications

• Researches, resolves, and documents patient inbound calls across multiple information systems.
• Addresses billing concerns for patients, including insurers, attorney representatives, and advocates.
• Investigates payment status and determines patient financial responsibility.
• Collects outstanding balances and offers payment options over the phone.
• Updates patient insurance information and escalates to AR team when needed.
• Soft follow-up on out-of-pocket costs and processing payments.
• Reconcilies patient balances (insurance vs patient).
• Collaborates with Accounts Receivable for claim resubmission.
• Sets up and manages patient payment plans.
• Handles credit card disputes.
• Coordinates with collection agencies on patient disputes.
• Uploads patient accounts in collection agency software.
• Manages bankruptcy cases per client protocol.
• Adheres to Billing Compliance Plan and privacy protocols.
• Complies with HIPAA, OSHA, PCI DSS regulations.

Job description

Job Title: Process Associate - CSR

Location: McKinley, Taguig

Work Set-up: Onsite

Job Description

• Researches, resolves, and documents patient (and other clientele) inbound calls involving a wide range of issues utilizing multiple information systems. This includes communications with internal business centers and external customers. Assures customer agreement by summarizing and closing each call appropriately.

• Answering Billing Concerns of the patients. This includes calls with insurance rep, attorney representatives and other patient’s representatives and advocates

• Investigates payment status and determines ultimate patient financial responsibility.

• Collect outstanding balance, offer patient assistance with financial responsibility through various financial options. Processing payment from the patients over the phone.

• Obtaining correct/updated insurance information to the patient. Includes adding the said insurance details to the PMS or escalating it over to AR Team to have it taken care of.

• Soft follow up on out-of-pocket cost to the patient’s processing payments over the phone

• Patient Collections

• Reconcile patient balance (insurance vs patient)

• Work with Accounts Receivable team for claim resubmission

• Setting up and managing payment plans

• Handling credit card disputes

• Collection Agency Collaboration

• Working collection agency patient disputes

• Uploading and maintaining patient accounts in collection agency software

• Bankruptcy

• Managing bankruptcy cases (Client Specific Protocol)

• Policies

• Work within guidance of Billing Compliance Plan

• Maintain and follow strict privacy, confidentiality, and safety protocols

• Comply with all government regulations around the following: HIPAA, OSHA, PCI DSS