Senior Customer Service Representative

Children's National Hospital; Silver Spring (MD); On-site; USD 27,000 - 45,000; Full time

Job summary

Children's National Medical Center in Silver Spring, MD seeks a Sr. Customer Service Representative to manage billing inquiries from parents and hospital staff, and to support charity processes and complex claims.

You will review accounts, resolve billing questions, and communicate complex billing concepts clearly to families, while coordinating with payors and hospital departments as needed. This role emphasizes accuracy, empathy, and compliance with regulatory guidelines.

Qualifications

• Account resolution and problem solving.
• Understand managed care contracting requirements and apply principles for assigned payors.
• Understand federal and state regulations surrounding billing for assigned payors (e.g., Medicaid).

Responsibilities

• Be the first point of contact for billing questions from parents regarding physician and hospital services.
• Review accounts and follow up to resolve billing concerns until needs are met.
• Communicate complex billing information in an understandable way to parents.

Skills

Account Resolution and Problem Solving

Managed care contracting

Billing regulations (Medicaid)

Education

High School Diploma or GED

Job description

12211 Plum Orchard Drive Silver 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.