The ASC Customer Service Representative II is responsible for analyzing case costing to ensure accuracy and profitability.
Job Relationships
- Reports to the ASC Manager-Billing Compliance and Optimization
Principal Responsibilities
- Monitoring ASC bad debt report for trends
- Acts as a liaison between the Ambulatory Surgery Center and the Patient Accounting / Revenue Cycle departments
- Works claim corrections and Athena edits as needed
- Prepare self-pay / underinsured self-pay quotes and communicates with Provider offices and Patient Advocate Team as necessary.
- Tracks all Cosmetic quotes, ensuring charge amounts and payment amounts are posted appropriately
- Performs analyses for each out of pocket /cosmetic patient for profitability and accuracy of quotes and provides real time feedback to Providers and Management.
- Assists with ROIs and reimbursement analysis as needed
- Monitors applicable reports to ensure profitability of cases. Follows specific ASC cases throughout the revenue cycle to ensure profitability. Advises ASC Billing Compliance and Optimization Manager and/or Director of Operations of potential reimbursement issues.
- Monitors ASC denial report and acts as a resource to help implement change moving forward
- Monitor reports and dashboards to ensure accurate case costing
- Takes initiative to teach and share new information and provide constructive feedback
- Answer questions regarding insurance coverage and other billing issues
- Maintain proficiency with insurance and billing issues by collaborating with Patient Accounting, Managed Care, and Operations. Participate in meetings and training sessions as appropriate.
- Acts as back up to the Customer Service Rep I as needed. Comply with the Springfield Clinic incident reporting policy and procedures.
- Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
- Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
- Perform other job duties as assigned.
Education/Experience
- High School graduate or GED required.
- Experience and familiarity with Medical Terminology or previous experience in any related medical field essential.
- Two to three (2-3) years’ experience in medical billing, insurance, coding knowledge preferred.
Knowledge, Skills and Abilities
- Required to attend in-services and workshops relevant to position.
- Must respect the security of Patient Confidentiality Statement.
- Must be able to work well with others, including patients, physicians, and other Clinic employees.
- Ability to work well under stress.
- Good organizational and communication skills.
- Demonstrate professional behavior.
- Computer knowledge is essential.
- Manual dexterity required for use of keyboard
Working Environment
- Office environment
- Working under stress and use of telephone required
- Some bending, stretching and light manual lifting required
- Requires sitting for long periods of time
PHI/Privacy Level
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