Representative - Payment and Support Operations L1

  POSITION SUMMARY

The Representative – Payment & Support Operations is responsible for the performance of the payment team under the direction of the Payment manager or supervisor.  This includes coordinating and facilitating the resolution of post-adjudication payments and credits for both patients and payers. 

ESSENTIAL FUNCTIONS

• Representatives will resolve accounts by taking inbound telephone inquiries, preparing patient statements, assisting patients with collections questions and assisting in the maintenance of patient account systems
• Appropriately resolve accounts with post-adjudication patient and credit balances and remove barriers to the team’s success.
• Work with other departments, including accounting and third parties to pursue and resolve patient balances and credits as well as payer credits.
• May work payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment to help the team meet goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing. 
• Builds strong working relationships with assigned business units, departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.
• Proposes and uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors and Revenue Cycle stakeholders accurately.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

MINIMUM QUALIFICATIONS
High school diploma/GED is required.
Requires knowledge of patient financial services or collections normally acquired over up to two years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

PREFERRED QUALIFICATIONS
Additional experience and/or education preferred.

Work experience with the Company’s systems and processes is preferred.

Previous cash posting, collections, and payment experience is preferred.

PHYSICAL DEMANDS/ENVIRONMENT FACTORS

OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager)

• Requires extensive sitting with periodic standing and walking.
• May be required to lift up to 20 pounds.
• Requires significant use of personal computer, phone and general office equipment.
• Needs adequate visual acuity, ability to grasp and handle objects.
• Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone.
• May require off-site travel

SUPERVISORY RESPONSIBILITIES

None

DIRECTLY REPORTING

Reports to the Supervisor – Payment & Support Operations

TYPE OF SUPERVISORY RESPONSIBILITIES

None

SCOPE AND COMPLEXITY

Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families, and all third-party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.