ASC Customer Service Representative II

The ASC Customer Service Representative II is responsible for analyzing case costing to ensure accuracy and profitability.

Job Relationships

• Reports to the ASC Manager-Billing Compliance and Optimization

Principal Responsibilities

• Monitoring ASC bad debt report for trends
• Acts as a liaison between the Ambulatory Surgery Center and the Patient Accounting / Revenue Cycle departments
• Works claim corrections and Athena edits as needed
• Prepare self-pay / underinsured self-pay quotes and communicates with Provider offices and Patient Advocate Team as necessary.
• Tracks all Cosmetic quotes, ensuring charge amounts and payment amounts are posted appropriately
• Performs analyses for each out of pocket /cosmetic patient for profitability and accuracy of quotes and provides real time feedback to Providers and Management.
• Assists with ROIs and reimbursement analysis as needed
• Monitors applicable reports to ensure profitability of cases. Follows specific ASC cases throughout the revenue cycle to ensure profitability. Advises ASC Billing Compliance and Optimization Manager and/or Director of Operations of potential reimbursement issues.
• Monitors ASC denial report and acts as a resource to help implement change moving forward
• Monitor reports and dashboards to ensure accurate case costing
• Takes initiative to teach and share new information and provide constructive feedback
• Answer questions regarding insurance coverage and other billing issues
• Maintain proficiency with insurance and billing issues by collaborating with Patient Accounting, Managed Care, and Operations. Participate in meetings and training sessions as appropriate.
• Acts as back up to the Customer Service Rep I as needed. Comply with the Springfield Clinic incident reporting policy and procedures.
• Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
• Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
• Perform other job duties as assigned.

Education/Experience

• High School graduate or GED required.
• Experience and familiarity with Medical Terminology or previous experience in any related medical field essential.
• Two to three (2-3) years' experience in medical billing, insurance, coding knowledge preferred.

Knowledge, Skills and Abilities

• Required to attend in-services and workshops relevant to position.
• Must respect the security of Patient Confidentiality Statement.
• Must be able to work well with others, including patients, physicians, and other Clinic employees.
• Ability to work well under stress.
• Good organizational and communication skills.
• Demonstrate professional behavior.
• Computer knowledge is essential.
• Manual dexterity required for use of keyboard

Working Environment

• Office environment
• Working under stress and use of telephone required
• Some bending, stretching and light manual lifting required
• Requires sitting for long periods of time

PHI/Privacy Level

• HIPAA1