Customer Resolution Specialist I

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

📋 Description

• Delivers outstanding customer service by addressing concerns and answering patient inquiries with the aim of achieving first-call resolution.

• Sets up financial arrangements, investigates patient disputes, and clarifies Revenue Cycle processes.

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

• Manages communications through email, fax, letters, Epic EMR, and Epic CRM in-basket.

• Notifies and escalates issues to leadership in writing when needed.

• Addresses HB and PB inquiries that involve insurance verification, benefits and eligibility, billing and payment concerns, treatment authorization, and explanations of benefits.

• Executes or requests adjustments and contractual write-offs as necessary.

• Collects or organizes payment plans for HB and PB self-pay balances while resolving related issues.

• Conducts presumptive charity determinations as applicable.

• Achieves daily productivity and quality benchmarks.

• Provides training or demonstrates tasks to other staff members or temporary employees when required.

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

• Follows Stanford’s CI-CARE principles and ensures excellent schedule adherence.

• Performs additional assigned tasks.

⛳️ Requirements

• A 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.

• Familiarity with government and non-government payer requirements, reimbursement rules, laws, and regulations governing billing and collection activities.

• Knowledge of medical terminology, CPT-4, ICD-9, HCPCS, modifier coding, and their impact on reimbursement.

• Comprehension of customer service principles and telephone etiquette.

• Ability to organize, plan, analyze, and solve problems.

• Strong attention to detail and follow-through.

• Excellent verbal and written communication skills.

• Proficient in Microsoft Office applications, specifically Word and Excel.

• Capable of clear communication in a fast-paced call center environment while multitasking.

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

• Working knowledge of all systems utilized in the department.

• An Associate's Degree in a business-related field is preferred.

• Experience with Epic Professional Billing is preferred.

• HFMA - Certified Rev Cycle Rep (CRCR) certification is preferred.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Generous paid time off and holidays.

• Retirement savings plan with employer matching.

• Opportunities for professional development and growth.

• Employee wellness programs and resources.