Specialist, SBO Resolutions

MedSrv

SBO Complaint Resolution Specialist Job Description

Job Title: SBO Complaint Resolution Specialist

Division: MedSrv

Reports to: Department Manager & Director

FLSA Status: Non-Exempt

Revised Date: February 2023

SUMMARY:

Communicates with patients/guarantors regarding any discrepancy, dispute, complaint, concern or contested matter by phone or email and attempts to fully resolve the patient's complaint in a timely manner.

ESSENTIAL DUTIES AND RESPONSIBILITIES.

Communicate with patients/guarantors by telephone/AdventHealth Everywhere portal and/or email to fully understand the patient's dispute/complaint/discrepancy and fully resolve the matter to patient satisfaction and obtains any other needed documentation for the resolution of the account.

Records information fully in all systems in which the issue may involve.

Updates and verifies new insurance information if/when provided by patient or guarantor.

Review, research or communicate with Practice Management or Department Manager or floor supervisor as necessary regarding any questionable accounts or issues presented by patient / guarantor

Review, research and communicate account questions or issues to practice management if / when needed via work que. Communication must be accurate and provide necessary detail for management to review.

Must be polite, courteous and accommodating to ensure good customer service is provided

Must have the ability to concentrate for extended periods of time.

Must be willing to function and cooperate as member of a team.

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

High school diploma or equivalent; or 1 year related experience and/or training; or equivalent combination of education and experience.

LANGUAGE SKILLS

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Ability to learn and comprehend basic medical terminology and protocols in order to handle patient accounts.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. Specific vision abilities required by this job include ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.