Job Title:
Customer Service Representative-PFS
Job Code:
5LT
Leader Title Level:
Supervisor
Location:
5050, 3850 Building
Department:
PATIENT FINANCIAL SERVICES Self-pay Collections
Final Approval (Dir. or VP Level)
Manager
Date Approved:
8/24/2016
Date Revised:
8/1/2023
POSITION SUMMARY STATEMENT:
The customer service representative thoroughly researches and resolves concerns related to billing, insurance, or the patient’s ability to pay. The customer service representative must ensure the patient concerns and issues are resolved in a timely and accurate manner in accordance with organizational policies and procedures, as well as the Attorney General Agreement and Federal regulations. The customer service representative perform tasks related to: obtaining payment over the telephone or in person from patient/guarantor, resolving patient’s balances by offering and accepting all appropriate payment arrangements, updating incomplete or missing information on accounts to ensure that billing is correct, provide accurate information and facilitate resolution to patients and third party inquiries, offering Financial Assistance and/or directing patients to the appropriate Government Assistance Programs. Always representing the company in a professional and positive manner and following the Attorney General Agreement and Federal regulations. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient’s satisfaction.
MINIMUM QUALIFICATIONS:
Education, Experience or Equivalent Combination:
One-year related work experience as a customer service/collections or revenue cycle professional.
Licensure/ Registration/ Certification:
Knowledge, Skills, and Abilities:
Self-motivation, problem resolution including professionalism and composure is required.
Moderate proficiency with word processing, spreadsheets and email is required.
Working knowledge of typical office equipment is expected.
PREFERRED QUALIFICATIONS:
Education, Experience or Equivalent Combination:
Licensure/ Registration/ Certification:
Knowledge, Skills, and Abilities:
Strong computer literate/typing skills.
Excellent verbal and written communication skills, including excellent phone etiquette.
Proactive problem solver, foster teamwork, and trust, be highly skilled in prioritizing and organizing.
Understanding of the Fair Debt Collection Practices, Attorney General Agreement, Affordable Care Act, and general familiarity with bankruptcy laws is preferred.
Strong communication and interpersonal skills, including ability to professionally respond in situations involving conflict and emotion.
Basic knowledge of accounting principles and accounts receivable systems also helpful.
Medical terminology and procedural/diagnostic coding knowledge helpful.
Proficiency in Electronic Medical Record preferred.
Preference for experience with the Microsoft Suite (e.g., Word, Excel, Outlook).
Essential Duties:
% Of Time (minimum 5% increments)
1.
Assists patients with billing inquiries on the phone or face to face and resolves patient concerns related to billing. Resolving patient concerns includes, thorough account research, providing the patient with necessary information regarding their account, setting up payment plans, offering Financial Assistance and providing information regarding Government Programs when applicable. Establishes appropriate plan of action in compliance with organizational procedures and policies State/Federal Regulations and high-quality customer service to ensure proper complaint resolution.
75%
2.
Review accounts in work queues that are past due to determine any outstanding patient concerns and reason balance owed. This may include performing outbound calls to patient/guarantor to inform of outstanding balance and assist in resolving all issues related to the account, determining acceptable payment plans, providing Financial Assistance information and direction on applying for Government Programs if applicable.
15%
3.
Establishes and maintains accurate and complete records and files. Documents all communication with external and internal contacts pertaining to patient accounts.
5%
4.
Performs other duties/special projects as assigned which may vary based on business need.
5%
*Job description rankings/percentages are intended to reflect normal averages over an extended period and are subject to daily variances. Quality and efficiency standards should at no time be compromised to meet the average expectations expressed above. Job descriptions are subject to change to accommodate organization or department needs.
ORGANIZATIONAL EXPECTATIONS:
Values
All colleagues are expected to live our values:
Excellence: We strive for the best results and always look for ways to improve.
Compassion: We care and show empathy and respect for each person.
Partnership: We are strongest when we work together and with those we serve.
Integrity: We are open and honest, and we keep our commitments.
Additional Expectations:
Complies with safety instructions, observe safe work practices, provides input on safety issues, and promotes a safe work environment.
Maintains regular and timely attendance.
Protects confidentiality.
Demonstrates participation in and support of the organization's Corporate Integrity Program by participating in compliance-related education and training and complying with the organization's policies and procedures.
Timely completion of all mandatory education and organizational requirements (i.e., licensure/certification, Employee Health and Wellness requirements, annual training, etc.)
POPULATION SPECIFIC COMPETENCIES:
X Yes
No
Does this employee have direct patient contact?
Departments will need to determine the appropriate competencies in their areas for their specific patient populations documented in the essential duties section.
Examples of items that can be included are:
• Identifies expected outcomes for a plan individualized to the patient or situation specific to the needs of the population served.
• Communicates effectively with patients, families, and team members.
• Integrates practices that supports patient safety, acknowledges variations in populations served.
• Anticipates the needs of the population served as well as the unique characteristics of the communities served.
• Anticipates the needs of the population in providing culturally responsive care and develops an individualized plan for patients and families.
LEADERSHIP RESPONSIBILITY:
Please describe the degree to which the position directs the work of others or coordinates workflow of a clinic, department, or functional area. If applicable, indicate the number of people and the titles for which this position directly and/or indirectly directs the work of others or coordinates workflow.
NA
Critical Job Demands
Section 1: Place an “X’ next to ONE of the terms that best describes the frequency for each of the Critical Demands.
Critical Demands
N/A
0%
Rare
1-5%
(Up to
a 1/2 hour)
Occa
6-33%
(1/2 hour
to
3 hours)
Freq
34-66%
(3 to
5½ hours)
Cont
67-100%
(5½ to
8 hours)
Standing - Remaining on one's feet in an upright position at a workstation without moving about.
Walking - Moving about on foot.
Sitting - Remaining in a seated position.
Squatting - Assuming or maintaining a crouching position with the knees bent.
Reaching - Stretching out or extending to touch or grasp.
Lifting - Raising or lowering an object from one level to another (includes upward pulling).
Carrying - Transporting an object, usually holding it in the hands or arms, or on the shoulder.
Pushing/Pulling – Exerting force upon an object so that the object moves away/towards from the force.
Handling/Fingering – (includes typing, computer work, gripping, grasping, and pinching)
Section 2: Place an “X” next to ONE of the terms that best describes the Strength Rating for this job classification which is expressed by one of five terms: Sedentary, Light, Medium, Heavy, and Very Heavy.
Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are more than those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.
Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. Physical Demand requirements are more than those for Light Work.
Heavy Work - Exerting 50 to 100 pounds of force occasionally, and/or 25 to 50 pounds of force frequently, and/or 10 to 20 pounds of force constantly to move objects. Physical Demand requirements are more than those for Medium Work.
Very Heavy Work - Exerting more than 100 pounds of force occasionally, and/or more than 50 pounds of force frequently, and/or more than 20 pounds of force constantly to move objects. Physical Demand requirements are more than those for Heavy Work.
Note: During any patient handling task, if any caregiver is required to lift more than 35 lbs. of a patient’s weight, assistive transfer devices should be used for the transfer.
HAZARD ASSESSMENT FOR PERSONAL PROTECTIVE EQUIPMENT (PPE) Please contact the employer Employee Health & Safety (EHS) with any questions or assistance related to the completion of the Hazard Assessment for Personal Protective Equipment (HAPPE) Form. RELATED TO: Hazardous Substances and Harmful Physical Agents Yes NoTask Description
Potential Hazard
Hazard control
PPE Required
Working with box cutters, knives, or other sharp cutting devices.
Penetration
Cut away from body.
Use proper tool for the job.
Safety knife or safety box cutter
Cut resistant gloves.
Other ___________________
Working with liquid chemicals, acids, or caustics (Examples: reprocessing, cleaners, disinfectants, laboratory chemicals).
See MSDS online database for chemical list
Chemicals
Flammables
Toxic Gases
Corrosives
Use only employer approved products.
Use appropriate soaking containers with labels.
Understand hazards of chemicals you use (read MSDS).
Goggles
Chemical face shield
Chemical resistant gloves
Chemical resistant aprons
Lab Coat
Closed toe shoes
Powered Air Purifying Respirator
Other ___________________
Exposed to extreme heat (Examples: Autoclaves, Blanket warmers, Ovens, Propane torches) or cold (Liquid Nitrogen, Winter temperatures).
Heat
Cold Stress, Burns, Frostbite
Approach hot surfaces carefully.
Use only approved liquid nitrogen Dewars. Dispense only if trained.
Heat resistant gloves
Cryogenic (cold resistant) gloves
Goggles
Face shield
Other ___________________
Driving or riding in motorized vehicle equipment as part of the job.
Vehicle crash, Impact
Absolutely no text messaging while driving.
Refrain from cell phone use while driving.
Seat belt
Other ___________________
Working in extremely wet or slippery conditions or working in 24/7 operations where floors are wet from mopping.
Slip, Trip, or Fall
For wet areas, mop excess water regularly.
Place warning signs.
Select footwear carefully
Slip resistant shoes.
Rubber boots
Other ___________________
Preparing or handling hazardous drugs (Examples: cytotoxic drugs, chemotherapy agents).
Chemical
Genetic damage
Tumors
Receive training.
PPE
Use of biological cabinet
Spill procedures
Waste disposal SOP
Gloves appropriate for chemical
Disposable barrier gown
Goggles
N95/PAPR (spill cleanup)
Ventilation Hood
Other ___________________
Medical/surgical procedures involving heat generating tools or equipment (Examples: cautery/ lasers).
Light radiation, burns to self or patient, smoke inhalation
Receive laser training.
Awareness and knowledge to minimize surgical or procedural fires.
Code Red training
PPE
Restricted access
Specialized laser safety glasses
Other ___________________
Working with or near ionizing Radiation Hazards (Examples: Radioactive sources, X-Rays).
Over exposure, Genetic damage
Warning signage
PPE
Waste and spill procedures
Personal monitoring
Shielding, distance
Lead Aprons
Other ___________________
Working near MRI.
Trauma resulting from missile effect
Restrict access.
Screening
Signage
Moving equipment/supplies.
Strain, Sprain
Proper body mechanics
Get additional help.
Get Ergonomic help from EOHS.
Dealing with agitated persons or disturbances.
Workplace violence, bodily injury, body fluid exposure
Training in verbal de-escalation techniques.
Code Green procedure
Gloves (Clean)
Barrier Gown or fluid resistant Lab Coat
Description
Potential Hazard
Hazard control
PPE Required
PERFORMING OR ASSISTING WITH THESE TASKS:
Potential for splash of blood/body fluid to face and clothing: examples but not all inclusive: suctioning, wound irrigation, eye & ear irrigation, close contact (within 3 ft.) of patient with frequent, productive cough, sigmoidoscopy, cystoscopy, colonoscopy.
Hand hygiene before and after task
PPE
Facial protection (mask plus goggles OR face shield)
Gloves (Clean)
Barrier Gown if anticipate splash
Activity that requires touching patient’s non-intact skin or mucous membranes.
Hand hygiene before and after task
PPE
Gloves (Clean)
Activity that includes touching patient’s blood/body fluid or contaminated items or environment, examples, but not all inclusive: disposal of urine, blood canisters.
Exposure to Infectious AgentsHand hygiene before and after task
PPE
Use of Spill kits (as needed)
Gloves (Clean)
Barrier Gown if anticipate splash.
Facial protection (mask plus goggles OR face shield) if anticipate splash.
Performing duties with sharp devices that could result in exposure to blood or body fluids.
Exposure to Infectious Agent/sharp injuryUse of sharps safety devices
Avoid re-capping needles.
Proper disposal of sharps at point of care
For reusable sharp, use safe transporting practices.
Use neutral zone for passing sharps.
PPE
Gloves (Clean vs. Sterile depends on the procedure)
Facial protection (mask plus goggles OR face shield) if anticipate splash.
Entering rooms where patients with airborne diseases are treated.
Exposure to Infectious Agent/inhalation
Mask patient
Place patient in airborne infection isolation room if available
Limit entry into room
Keep door closed.
PPE
Work with specimens from patients with airborne diseases.
Exposure to Infectious Agent/inhalationPPE
Biological Safety hoods/cabinet instrumentation with automated/closed sampling mechanisms
N95 respirator or PAPR
1. Procedures that enter deep tissue or body fluid, including but not limited to:
Central IV insertion, placing a catheter or injecting material into the spinal canal or subdural space (myelogram, lumbar puncture, spinal/epidural anesthesia), breast biopsy, temporal artery biopsy, bone marrow biopsy, OB vaginal delivery, incision & drainage.
Hand hygiene before and after procedures
PPE
Gloves (Sterile)
Barrier Gown
Facial protection (mask plus eye protection or face shield plus mask required during these procedures)
2. a. Procedures that enter
subcutaneous tissue or are located.
in the skin structure, including but
not limited to:
Excision of mole, lump, or bump
Excision of lipoma or sebaceous cyst, vasectomy
Hand hygiene before and after procedure
PPE
Facial protection (mask and eye protection required during these procedures if anticipate splash)
Gloves (Sterile)
Barrier Gown if anticipate splash
2. b. Additional Procedures
Shave biopsy, punch biopsy
Joint injection, nerve injection, joint aspiration
Peripheral IV insertion, ENT procedures
Anal-rectal Biopsy
Exposure to infectious agents
Hand hygiene before and after procedure
PPE
Gloves (Clean)
Barrier Gown if anticipate splash.
Facial protection (mask and eye protection required during these procedures if anticipate splash)
3. Handling Lab specimens in a laboratory
Exposure to infectious agents
Hand hygiene after removing gloves.
PPE
Biological Safety hoods/cabinet
Splash guard
Instrumentation with automated/closed sampling mechanisms
Lab Coat (fluid resistant)
Gloves (Clean)
Facial protection (mask plus eye protection or face shield plus mask required during these procedures)
Other tasks with identified safety, health or infectious hazards requiring PPE?
Yes No Task DescriptionHazard
Hazard control
List PPE required
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At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.
We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.
At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.
Join us and become a partner for good, helping to improve the health and well-being of our patients, members and the communities we serve.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.
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