Senior Customer Service Representative

Children's National Hospital; Pittsburgh (Allegheny County); On-site; USD 27,000 - 45,000; Full time

Job summary

Children’s National Hospital in Silver Spring, MD seeks a Sr. Customer Service Representative to respond to parents and hospital staff about billing and insurance concerns.

You will facilitate the charity process and handle complex billing inquiries related to physician and hospital services. The role requires a High School Diploma or GED and 4–5 years of medical billing office experience, with knowledge of managed care contracting and Medicaid regulations.

Qualifications

• High School Diploma or GED required.
• 4–5 years medical business office experience.
• Knowledge of managed care contracting and billing regulations.

Responsibilities

• Be the first point of contact for billing complaints from parents.
• Resolve billing concerns by reviewing accounts and following up until resolved.
• Explain complex billing information to parents in understandable terms.
• May provide additional account itemization and interpret EOB letters.
• May contact third-party payors to obtain information.
• Support process: file Financial Assistance Program data and adjust overpayments.

Skills

Account resolution

Problem solving

Managed care contracting

Billing regulations (Medicaid)

Education

High School Diploma or GED

Job description

12211 Plum Orchard DriveSilver Spring, MD 20904

Kids Are Our Everything.

Department

10121 Patient Cash Application

Pay Range

$19.65 - $32.75

The Sr Customer Service Representative will respond to parents and hospital staff regarding billing and insurance complaints of physician and hospital services. The representative will be responsible for facilitating the hospital’s charity process and billing special program claims and accounts. The Sr Customer Service Representative will also assist with complex billing inquiries.

Minimum Education

High School Diploma or GED (Required)

Minimum Work Experience

4 years 4-5 years medical business office experience (Required)

Required Skills/Knowledge

• Account Resolution and Problem Solving.
• Understand managed care contracting requirements and applies principles for assigned payors.
• Understand federal and state regulations surrounding billing as it applies to assigned payors, e.g., Medicaid.

Functional Accountabilities

Parent Communication

• Be the first point of contact for billing complaints and receive calls from parents in regard to billing questions for physician and hospital services.
• Work with parents to resolve billing concern by reviewing accounts and follow-up until needs are met.
• Be able to communicate with parents about complex billing information in a way that parents can understand.
• May provide further account itemization to parents; interpret EOB letters for parents; may provide information of legal matters, with appropriate authorization.
• May contact third party payors on behalf of parents to obtain additional information.

Research Patient Billing Issues

• Develop detailed knowledge of internal billing systems to research billing inquires for both physician and hospital services.
• Integrate information from multiple systems to develop responses to parents’ concerns.
• Document actions in system including research findings, write-offs, documentation sent, documentation requested etc.
• May add insurance information to systems.

Support

• Process, record, and file Financial Assistance Program Application data in a timely manner.
• Review accounts and prepare adjustment forms; adjust overpayments and post errors to accounts.

Complaint Resolution

• Identify source and work to resolve issues with hospital management; refer unresolved issues to manager .
• Responsible for final communications with parents or hospital staff when complaints are resolved.
• Responsible for assisting with training customer Sservice staff on timely account resolution to avoid complaints.

Billing Services

• Responsible for billing DC, MD & VA Crime Victims Claims; responsible for billing and reconciling Amish Accounts; monitor and resolve the Global Services Department Self Pay Accounts; make sure all payments and adjustments are posted timely.
• Within identified parameters, write-off account balances; recommend and refer larger write-offs to manager for approval, provide supporting documentation.

The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children’s National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual’s combination of prior work experience, level of education, knowledge, skills, and other qualifications. Children’s National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible.

Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here:Know Your RightsPay Transparency Nondiscrimination Poster.

Please note that it is the policy of Children’s National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children’s National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana.