Customer Service Agent (Full Time, Days) at Nicklaus Children's Health System in Miami, Florida

Job Description:

Job Summary

Receives incoming queued calls from families and patients related to billing questions or discrepancies for the hospital, UCC's, and PSA offices.

Minimum Job Requirements

• 1-3 years Experience working with patient accounts

Knowledge, Skills, and Abilities

• One year of experience working with medical terminology, procedures, diagnosis codes, and insurance strongly preferred.


• Fluency in speaking Spanish highly preferred.


• Knowledge of medical third party payor software a plus.


• Excellent customer relations skills.


• Excellent understanding of HIPAA regulations.


• Basic knowledge of Word, Excel, and Outlook


• Ability to accurately enter and interpret data.


• Able to co-relate cooperatively and constructively with clients and co-workers.


• Able to maintain confidentiality of sensitive information.


• Ability to follow detailed written or verbal instructions.

Job Specific Duties

• Receives incoming queued calls from patients and families related to billing including billing discrepancies and disputes for the hospital, UCC’s, and PSA offices.


• Educates parents regarding their financial obligations for services rendered. Verifies patient’s relationship to caller, ensures guarantor, primary & secondary insurance information is correct.


• Collaborates with multiple stakeholders in order to resolve billing discrepancies including internal departments as well as external third parties contracted for billing services.


• Provides follow up and status reports to parents who call in pending a resolution to their issue.


• Identifies accounts that need to be re-assigned or recalled when they have been placed with the incorrect vendor and notifies Manager for processing.


• Determines resolution step (i.e. apply credit, request refund, adjustment or audit) & attaches action code in Cerner to instruct internal departments on what is next step in process resolution.


• Contacts vendor liaison via email or phone in order to place the account with the correct stake holder when necessary.


• Documents all calls into the electronic medical record in Cerner, in order to accurately capture as much detail as possible.


• Places request for audit of record by the Revenue Integrity team when a parent disputes receiving a service or charge.


• Provides alternatives to help the guarantor with outstanding balances. Advises on optional payment plans and financial charity options available if the applicant meets the requirements.


• Complies with applicable governmental regulations such as HIPPA (Health Information Portability and Accountability Act of 1996).


• Provides documentation requested by guarantor including itemized bills/statements, & detailed statements from physician account, financial evaluation charity application, & receipt of payments.


• Educates global health patients regarding billing options. Investigates if a contract is in place with global and collaborates with Global Health department regarding resolution.


• Processes payments as needed, tracks payment history, transfers payments using virtual cash register software and closes register at end of each day.


• Identifies duplicate financial and medical record numbers, and handles as appropriate.