Patient Resolution Specialist - Remote

Med-Metrix; Red Bank (NJ); On-site; USD 40,000 - 60,000; Full time

Job summary

A healthcare solutions provider based in Red Bank, NJ is seeking a Patient Resolution Specialist to manage inbound and outbound calls from patients, ensuring payment collection and resolving inquiries. Candidates should have a high school diploma and at least 5 years of healthcare-related experience, including 1 year in a call center. Strong negotiation, problem-solving skills, and knowledge of reimbursement processes are essential. The role involves meeting quality standards and safeguarding patient information under HIPAA rules.

Qualifications

• 5+ years of experience in a related role, with 1+ year in a call center environment.
• Strong knowledge of healthcare reimbursement processes.
• Excellent written and verbal communication skills.

Responsibilities

• Manage a high volume of inbound and outbound calls from patients.
• Resolve patient account inquiries and collect payment.
• Research various insurance or payment options for patients.

Skills

Customer service skills

Negotiation skills

Problem-solving skills

Interpersonal skills

Attention to detail

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

Job Purpose

The Patient Resolution Specialist manages a large volume of inbound and outbound calls in a timely manner, to patients of our client hospital and health systems, to secure payment of outstanding account balances, resolve account inquiries, and investigate and document status of these account activities. The Patient Resolution Specialist has ownership for effectively resolving patient inquiries and advancing payment of patient account receivables while keeping patient satisfaction at the core of every interaction.

Duties And Responsibilities

• Manage a continuous and high volume of in-bound and out-bound calls from patients, health systems, and insurance carriers, while simultaneously navigating and updating numerous systems, to resolve patient accounts inquiries and collect payment
• Attain payment of outstanding patient accounts through use of effective negotiation and customer service skills
• Accurately records status of collection efforts in company and member systems
• Research alternate insurance or payment options from various client resources available while navigating and updating multiple patient accounting systems.
• Assess caller status to ensure the protection of patient privacy and compliance with State and Federal guidelines
• Responsible for meeting monthly goals and quality standards through efficient and accurate work processes
• Other duties as assigned
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

• High school diploma or equivalent required
• At least 5 years’ experience working in a related role, with at least 1 year experience working in an inbound/outbound call center environment
• Strong working knowledge of the healthcare reimbursement process
• Working knowledge of Microsoft Office applications
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction

Working Conditions

• Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.