Customer Service Billing Representative -Winter Garden/Bilingual English & Spanish


**This position will require face-to-face training in Winter Garden and will be remote after 90 days and the successful completion of the face-to-face training **

A career at Community Health Centers offers a unique opportunity to join a team that makes a real impact in our community every day, by improving individuals' health while enhancing their quality of life.

Top Reasons to Work at Community Health Centers

  • No weekends for the majority of our centers, 10 Paid Holidays and early Fridays
  • A great benefits package that includes healthcare coverage, paid time off, paid holidays, retirement plan, and more.
  • Competitive compensation with advancement opportunities and tuition / training reimbursement.
  • Awarded "Best and Brightest Companies to Work for in the Nation" for 5 consecutive years.
  • Awarded "Top 100 Workplaces for Growing Families" by Orlando Sentinel.
  • Modernized and attractive health centers, that patients love.

Job Summary:

Responsible for handling inbound and outbound calls related to billing inquiries, payments, and account management. The primary focus of the Customer Service Billing Representative will be to assist customers in resolving billing issues, providing information on billing processes, and ensuring timely and accurate processing of payments. This role requires excellent communication skills, attention to detail, and a customer-centric approach to delivering high-quality service.

Primary Responsibilities and Specific Duties:

Customer Service Duties:

Handle a high volume of inbound and outbound calls from customers regarding billing inquiries, account balances, payment processing, and billing disputes.

Provide accurate and detailed explanations of billing statements, charges, fees, and payment options to customers.

Assist customers in updating account information, including contact details, billing addresses, and payment methods.

Process payments over the phone, including credit card transactions, electronic ensuring accuracy and security.

Set up payment plans with patients

Collaborate with team to address complex billing issues and escalate unresolved issues as needed.

Document all customer interactions, inquiries, and resolutions accurately and thoroughly in eClinicalWorks and Transworld when needed.

Verify Insurance Plans through various web portals as needed.

Follow established protocols and procedures for handling sensitive customer information and adhering to privacy regulations, such as HIPAA.

Provide excellent customer service by actively listening to customers, empathizing with their concerns, and demonstrating a willingness to assist and resolve issues.

Meet or exceed performance goals and metrics, including call handling time, customer satisfaction scores, and resolution rates.

Stay updated on changes to billing policies, procedures, and regulations, and communicate relevant updates to customers as needed.

Billing Duties (as needed):

Reviews claims for accuracy in accordance with Medicare, Medicaid, and Managed Care policies.

Transfers balances to patient's responsibility on non-covered items, benefits denied, or charges applied to the deductible.

Self-Pay Collection:

Reviews and appropriately places account claims in the collection management system in eCW.

Following collection guidelines, sends collection letters and establishes phone conversations concerning outstanding balances.

Establishes payment arrangements with responsible parties for outstanding balances.

Processes all returned mail according to established policy and procedure.

Processes all incoming patient correspondence and answers all patients' questions regarding their account balance.

Processes electronic file for monthly patient statements.

Makes necessary adjustments to correct patient accounts for correct billing.

Provides recommendations to Patient Accounts Receivable Manager regarding account disposition (collection agency placement, write-off discharge, etc.).

Ensures accuracy of payments received from third party payers per contracts and current reimbursement rates.

Posts contractual adjustments as required to Medicare, Medicaid, HMO, PPO and other accounts per contracts and current reimbursement rates.

Collects and posts payments, completes appropriate forms/reports, and submits daily to Patient Accounts Receivable Manager and Accounting Assistant.

Performs all other duties as assigned.


QUALIFICATIONS:

Education:

High School Diploma or equivalent is required.

Experience:

Previous experience in a call center environment, preferably in billing, customer service, or financial services required.

Experience with Microsoft Office Software including Outlook, Word and Excel preferred.

Special Skills:

Bi-lingual Spanish required.

Additional Skills:

Strong verbal communication skills with clear and professional phone manner.

Excellent active listening skills with the ability to understand and address customer needs and concerns effectively.

Ability to multitask, prioritize tasks, and work efficiently in a fast-paced environment.

Strong problem-solving skills with the ability to think critically

Attention to detail and accuracy in data entry and documentation.

Ability to remain calm and composed under pressure and handle challenging customer interactions with professionalism and empathy.

  • Must have good communication and customer service skills.