Customer Resolution Specialist

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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview
Responsible for performing customer care activities in accordance with applicable Federal, State and local standards, guidelines and regulations. These responsibilities include but are not limited to customer service, billing and/or patient account balance collection activities associated with the hospital and professional revenue cycle.

Locations
Stanford Health Care

What you will do

• Performs or requests adjustments and contractual write offs as applicable
• Maintains a thorough understanding of hospital and professional billing procedures and payment practices of state, federal and all third party payers.
• Resolves HB and PB customer service inquires which could include:
  Benefit and eligibility information
  Billing and payment issues
  Authorization for treatment
  Explanation of benefits (EOB)
• Perform timely and efficient collection of all HB and PB self-pay balances by calling patients/guarantors and others to collect or arrange budget plan options and resolve issues.
• Performs presumptive charity determinations as applicable.
• Performs bad debt request transfers as applicable.
• Ensures daily productivity standards of assigned accounts are met and posting of all action codes related to patient's accounts
• Maintains a thorough, practical understanding of departmental established policies and procedures
• Other duties as assigned

Education Qualifications

• High School diploma or GED equivalent

Experience Qualifications

• Three (3) years of progressively responsible and directly related work experience

Required Knowledge, Skills and Abilities

• Government/non-government payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities
• Medical terminology, CPT-4, ICD-9, HCPCS, modifier coding and how these items drive reimbursement
• Principles and practices of customer service and telephone courtesy
• Organizational, planning, analytical and problem solving skills
• Attention to detail and follow-through
• Demonstrated verbal and written communication skills
• Microsoft Office applications (Word and Excel)
• Epic Professional Billing preferred

Licenses and Certifications

• HFMA - Certified Rev Cycle Rep (CRCR) preferred

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

#LI-RL1

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.