**Billing Customer Resolution Specialist (52042)**
+ Job Type:Full Time
+ FTE/Bi-Weekly Hours:1.0/80
+ Hours in Shift:8
+ Location:Palo Alto, CA
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient's rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.
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. 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.
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Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: High School diploma or GED equivalent
Experience: Three (3) years of progressively responsible and directly related work experience
License/Certification: HFMA Certified Revenue Cycle Representative (CRCR) certification preferred.
Knowledge, Skills, and Abilities:
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.
Government/non-government payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities
Medical terminology, CPT-4, ICD-10, 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
SHC does not discriminate on the basis of Ancestry, Age, Color, Disability, Genetic information, Gender, gender identity, or gender expression, Marital status, Medical condition, Military or veteran status, National origin, Race, Religion, Sex, and Sexual orientation.