Customer Resolution Specialist (52042)

Stanford Health Care

Palo Alto,CA  

2020-01-18 2020-02-17
administration hospital

For over 160 years, Stanford Health Care has been advancing medicine together as fearless leaders and unstoppable patient advocates. Consistently ranked among the nation’s best hospitals, we are a team of pioneers, bringing groundbreaking medical research and patient care to the communities we serve every day.

We’re Stanford Health Care, home to health care professionals making the impossible a reality every day. We’re pushing the boundaries of what medicine can do, and that takes people who can lead fearlessly, challenge the expected, and inspire healing in everything they do. Your courage, your compassion, and your relentless pursuit of excellence are welcome here. We invite you to explore our current opportunities and discover the rewarding next step in your career.



**Customer Resolution Specialist (52042)**



+ Job Type:Full Time

+ FTE/Bi-Weekly Hours:1.0/80

+ Shift:Days

+ Hours in Shift:8

+ Location:Palo Alto, CA

+ Req:52042



**Job Description**



Essential Functions

The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.



Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patient's rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings.



Performs or requests adjustments and contractual write offs as applicable.

Maintains a thorough understanding of hospital and professional billing procedures and payment practices of state, federal and all third party payers.

Resolves HB and PB customer service inquires which could include:

Benefit and eligibility information

Billing and payment issues

Authorization for treatment

Explanation of benefits (EOB)

Perform timely and efficient collection of all HB and PB self-pay balances by calling patients/guarantors and others to collect or arrange budget plan options and resolve issues.

Performs presumptive charity determinations as applicable.

Performs bad debt request transfers as applicable.

Ensures daily productivity standards of assigned accounts are met and posting of all action codes related to patient's accounts.

Maintains a thorough, practical understanding of departmental established policies and procedures.

Other duties as assigned. Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.



National recognition in 10 specialties.



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"We have a culture of patient care first here, one that speaks to our mission and our values: to care, to educate, and to discover."



Brian L.Unit EducatorBSN, CMS RN



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196Stanford Health Care uses 196 solar panels, powering 17% of the hospital's electricity.



17In 2015, we had 17 dogs in our Pet Assisted Wellness (PAWS) Program.



8We're proud to work with 8 All-time Stanford Medicine Nobel Laureates.



1,592Stanford Health Care exhibits more than 1,592 original art pieces.



**Qualifications**



Minimum Requirements

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Education: High School diploma or GED equivalent

Experience: Three (3) years of progressively responsible and directly related work experience

License/Certification: HFMA Certified Revenue Cycle Representative (CRCR) certification preferred.



Knowledge, Skills, and Abilities:

These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.



Government/non-government payer requirements, reimbursement rules, laws and regulations that govern billing/collection activities

Medical terminology, CPT-4, ICD-10, HCPCS, modifier coding and how these items drive reimbursement

Principles and practices of customer service and telephone courtesy

Organizational, planning, analytical and problem solving skills

Attention to detail and follow-through

Demonstrated verbal and written communication skills

Microsoft Office applications (Word and Excel)

Epic Professional Billing preferred



SHC does not discriminate on the basis of Ancestry, Age, Color, Disability, Genetic information, Gender, gender identity, or gender expression, Marital status, Medical condition, Military or veteran status, National origin, Race, Religion, Sex, and Sexual orientation.
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