Prisma Health ยท 1 month ago
Single Billing Office, Customer Service Specialist, FT, Days, - Remote
United States
Full-time
Remote
Entry, Mid Level
2+ years expPrisma Health is dedicated to transforming healthcare for the benefit of the communities they serve. They are seeking a Customer Service Specialist to handle hospital and physician accounts, assist patients with inquiries, and resolve billing concerns while ensuring compliance with privacy and regulatory requirements.
Health CareHospitalMedical
Responsibilities
Performs tasks of moderate to difficult complexity relating to both hospital and physician accounts
Handles a large volume of inbound calls
Responsible for also making outbound calls related to self-pay follow up on accounts
Assists patients with requests for information, complaints, and resolving issues
Responsible for data analysis and interpretation throughout all functions of revenue cycle, to determine reasons for denials, non-payment and overpayment, post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances and analysis/movement of unapplied, unidentified, undistributed balances
Moderate to difficult levels of evaluation, analysis, decision making required in these roles
Resolves billing concerns, addresses inquiries related to insurance concerns/matters, assist patients with MyChart while simultaneously establishing a rapport with our diverse field of patients
Reviews accounts to determine insurance coverage; obtains and corrects any missing or inaccurate information
Discusses patient responsibility, which includes educating patients on claim processing, deductible, coinsurance, and co-pays
Interacts with patients by making patients aware of payment options such as payment plans and financial assistance as well as how to apply for financial assistance if circumstance warrant
Ability to set up payment plans in MyChart based on patient's personal needs
Greets patients in a professional and courteous manner
Communicates clearly and professionally in both oral and written communication
Be clear and concise in all communication to ensure patients understand the information that is being communicated to them by the Customer Service Specialist
Maintains a high level of poise and professionalism in dealing with patients
Knows when to escalate a patient service issue real time
Research customer requests or issues, determines if further action is needed, forwards to appropriate party for resolution, and exercises good judgement to determine urgency of patient's need
Contacts payer and makes hard inquiries on account status if needed
Escalates problem accounts to the appropriate area(s)
Documents billing activity on a patient's accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders
Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for any potential further analysis if needed
Ensures all work is compliant with privacy, HIPAA, and regulatory requirements
Participates in general or special assignments and attends all required training
Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance
Answers all incoming calls from Prisma Health patients
Performs other duties as assigned
Qualification
Required
High School diploma or equivalent OR post-high school diploma / highest degree earned
Two (2) years billing, bookkeeping, and/or accounting experience
Knowledgeable of the job functions required for a A/R Follow-up Representative, Cash Posting Representative, Claims Clearinghouse Representative, Correspondence Representative, Credit Processing Specialist, Denial/Appeals Specialist, Payment Research Specialist and a Quality Assurance Specialist
Knowledgeable of the entire Revenue Cycle and Epic
Company
Prisma Health
Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually.
10001+ employees
H1B Sponsorship
Prisma Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (1)
2022 (1)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
CDA Foundation
2024-07-30Grant
Leadership Team
Mark O'Halla
President & CEO
B
Barrett Ludley
Facility Chief Financial Officer
Recent News
2026-01-16
Precedence Research
2025-09-09
Company data provided by crunchbase