Customer Resolution Specialist I

This is a fully remote position, open to applicants in California.

📋 Description

• Deliver outstanding customer service and address patient concerns and inquiries with the aim of achieving first-call resolution.

• Set up financial arrangements, investigate patient disputes, and clarify revenue cycle processes.

• Record customer interactions in the Epic Electronic Medical Record (EMR) system.

• Address communications received via email, fax, letters, Epic EMR, and Epic CRM in-basket.

• Communicate and escalate issues to leadership in writing when necessary.

• Address hospital billing (HB) and professional billing (PB) inquiries, including insurance verification, benefits and eligibility, billing and payment issues, treatment authorization, and explanations of benefits.

• Execute or request adjustments and contractual write-offs as needed.

• Collect or establish budget plans for HB and PB self-pay balances while resolving associated issues.

• Conduct presumptive charity determinations as applicable.

• Meet daily productivity and quality metrics.

• Train staff members or temporary employees on job responsibilities when required.

• Maintain a comprehensive understanding of departmental policies, hospital and professional billing procedures, and payer payment practices.

• Comply with Stanford’s CI-CARE principles and ensure adherence to scheduled commitments.

• Carry out other assigned tasks.

⛳️ Requirements

• High School diploma or GED equivalent, or equivalent work experience is required.

• At least one (1) year of progressively responsible experience in customer service, payment collection, medical billing terminology, Electronic Medical Record (EMR) systems, or call center roles, preferably within the healthcare sector.

• Knowledge of government and non-government payer requirements, reimbursement rules, and regulations governing billing and collection activities.

• Familiarity with medical terminology, CPT-4, ICD-9, HCPCS, modifier coding, and reimbursement factors.

• Understanding of customer service principles and telephone etiquette.

• Capability to organize, plan, analyze, and solve problems effectively.

• Keen attention to detail and commitment to follow-through.

• Excellent verbal and written communication skills.

• Proficiency in Microsoft Office applications (Word and Excel).

• Ability to communicate clearly in a fast-paced call center environment and manage multiple tasks simultaneously.

• Ability to document actions taken while managing accounts and handling calls in a high-velocity call center setting.

• Working knowledge of all departmental systems.

🏝️ Benefits

• Comprehensive health benefits.

• Competitive salary with performance-based incentives.

• Opportunities for professional development and growth.

• Supportive work environment focused on teamwork and collaboration.

• Flexible scheduling options.