Customer Service Representative - Part Time Day Shift

Job Summary: 

Customer Service Representative- Responsible for inputting accurate data into excel spreadsheets. Pull data for audits and assist with special projects and or backlogs within the office. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication. 

Customer Service Representative: Government Support- Responsible for maintaining current Government & TAR logs with accurate information. Pulling, scanning, and copying documents. Assist Government staff with requests, as well as vendor requests. Documents appropriately EOB’s & R/A’s.  Assist in audits and special projects. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Customer Service Representative: Agency-Charity Liaison Analyst- Position is responsible to review accounts and analyze for Bad debt assignments. Responsible to review and process accounts for financial assistance and Charity. Must document and appropriately work agency logs/requests for Insurance updates and adjustment requests. Maintain assignment and reconciliation logs in a timely and efficient manner. Assist in the department as needed to provide support in other functions. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Essential Functions: 

• Compiling data and completing bad-debt logs to include all Medi-Cal/Medicare Managed Care products.
• Retrieve all documents for Bad-Debt logs.
• Ensure all data is accurate on logs by validating against financial systems and paper EOB’s.
• Pull data for all upcoming audits.
• Demonstrates competency when entering data into excel spreadsheets.
• Demonstrates competency when locating and pulling for special reports/projects in a timely manner.
• Demonstrates competency when locating and removing requested information.
• Meets all audit deadlines established.
• Demonstrates competency when investigating missing information by searching in current and in legacy systems.
• Assist in the billing areas when needed.
• Assist when needed in scanning and indexes all documents received within a timely manner.
• Performs all other duties and special projects as assigned.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
• Completes and attends monthly training assigned.

 Government Support-

• Responsible to maintain accurate Tar Pending Log in a daily basis.
• Runs spot check for all Medi-Cal cards that are received via mail.
• Pulls explanation of benefits for Collectors to bill secondary payor.
• Pull and copy Medicare / Medi-Cal Remittance Advice for collectors and auditors in timely manner.
• Request for Medical records as needed.
• Complete package for vendors for assignment.
• Keeps logs for Medi-Cal and Medicare Remittance Advices timely and appropriately.
• Responsible to log any outstanding requests for billing.
• Performs other job-related tasks, and special projects as assigned.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations and attends monthly training assigned. 

 Agency-Charity Liaison-

• Monitor and/or follow-up with precise documentation and reporting of pre-bad debt and bad debt accounts assigned to collection agency to ensure accurate assignment and assigned account balances.
• Accurately utilizing the appropriate activity, status, and agency codes; reviews and approves or denies collection assignments in a timely manner.
• Assures patient(s) bankruptcy notice(s) is a discharge of debt, for the correct dates, and assigns those accounts to the appropriate bad debt agency code.
• Appropriately recalls patient accounts from bad debt, and re-status accounts back to A/R in a timely manner.
• Reviews/ validates agency payments and fees for Management invoice approval.
• Accurately documents agency status activity in Paragon system and responds to agency requests timely.
• Works closely and builds positive working relations with collection agency, attorney(s), and ancillary departments.
• Updates and maintains agency activity and assignment logs, by facility and agency. Ensure appropriate Insurance updates are completed timely. Request appropriate adjustments as needed.
• Reviews all agency logs/reports for accuracy, and e-mails to appropriate Management Team.
• Performs quality completeness review of patient Uncompensated Care (Charity Care) and Discount Assistance programs.
• Reviews and acknowledges Financial Assistance applications, and request for additional documentation in a timely manner.
• Assures completed applications sent for review and approval efficiently and timely.
• Handles Financial Assistance in a caring and professional manner.
• Performs all other duties and special projects as assigned in an organized and timely manner.
• Complies with Federal, State, and Local Laws that govern business practices.
• Understands and abides by all departmental policies and procedures as well as the Code of Ethics, HIPAA requirements and patient rights.
• Pull data for all upcoming audits timely and efficiently.
• Meets all audit deadlines established.
• Demonstrates competency when investigating missing information by searching in current and in legacy systems.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
• Completes and attends monthly training assigned.

Behavioral Standards: 

• Exhibits customer and service-oriented behaviors in everyday work interactions.
• Demonstrates a courteous and respectful attitude to internal workforce and external customers.
• Communicates accurately and appropriately.
• Works well and efficiently under minimal supervision.
• Handles difficult situations in a discreet and professional manner.
• Is adaptable to changes in assignments and priorities.

Communication/Knowledge: 

• Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer’s and co-worker’s time; establishes and maintains effective relationships with customers and co-workers.
• Provides accurate and timely written and verbal communication of information in a manner that is understood by all.  
• Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome. 
• Able to use IT systems in an accurate and proficient manner

Collaboration/Teamwork: 

• Contributes toward effective, positive working relationships with internal and external colleagues. 
• Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.

Qualifications/Experience: 

• Clerical experience preferred.
• Must be able to multi-task.
• Proficient in Excel skills.
• Analytical skills.