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Mass General Brigham

Customer Service Representative I

Mass General Brigham, Somerville, Massachusetts, us, 02145

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Customer Service Representative I

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Mass General Brigham

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not‑for‑profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high‑performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary The team is growing and hiring Remote Customer Service Representatives! The teammates in Patient Billing Solutions (PBS) review and resolve guarantor account balances. Contact with guarantors can be either inbound contacts or outbound contacts that are generated by phone, written correspondence, email or secure Epic in‑basket requests. Primary focus includes timely responses to guarantor inquiries generally matching the method that was used to contact PBS.

Account resolution takes many forms including securing payments, making appropriate adjustments, initiating reviews of insurance processing, refunding guarantor balances or resolving a wide range of registration, demographic or insurance coverage issues. Some guarantor accounts will be queued for action due to the account being placed in a Work Queue that is designated for action by a PBS team. Most staff will have some responsibility to answer phone calls via an Automated Call Distribution (ACD) process (i.e. Call Center). This responsibility will vary based on the specific team assignment.

Account resolution typically requires expertise in multiple modules in Epic, including HB Resolute, PB Resolute, Registration/ADT and Credit Specialist training. Broad based knowledge of medical billing and insurance processing is also required. Staff must be able to respond knowledgeably to a wide range of issues for every contracted and non‑contracted payer, including government and non‑government payers presenting their findings professionally in language that the guarantor can understand. Staff must be diligent in following HIPAA Privacy guidelines.

The primary goal of PBS is to resolve the guarantor’s concerns focusing on providing excellent customer service that enhances their overall experience with MGB.

What You’ll Do

Respond to patient/guarantor/customer concerns which span a wide range of issues including payer denials, coding accuracy/appropriateness, secondary billing, coordination of benefits, verification of copayments/coinsurance/deductibles and verification/updates to demographic/insurance information and fiscal registrations to verify the patient’s responsibility for all outstanding balances. Verification process routinely includes contacting other departments at MGB/RCO/entities, payers, affiliated physician organizations and other vendors (collection agencies and other outsource agents).

Apply credit & collection policy and financial assistance policy and inform patients of all assistance available to them when making payment arrangements, processing payments, application, or referring patients to financial counseling.

Provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries. Whenever possible, resolve issues during the initial telephone call. Verify the patient’s fiscal and demographic information at every opportunity and make appropriate updates to various billing systems to ensure claims are processed appropriately and Medicare as a secondary payer questionnaire. Resolve complex issues with minimal external or supervisory involvement. Document all patient interactions and account actions in assigned billing systems to establish a clear audit trail.

Obtain information from and perform actions on accounts in Epic (HB and PB Resolute) and for selected HB accounts, TRAC and QUIC. Look up information in other support systems as needed including, but not limited to, Legacy Data Access LDA, document imaging (OnBase), eligibility verification systems (NEHEN, payer web sites) and other document backup (Sharepoint) to identify root cause issues. Use systems and information to resolve issues and respond to the patient’s inquiry. Obtain information from internal third‑party payer units, intermediaries for professional practices and hospital departments, payers, ambulance companies and other hospitals/home health/rehab facilities to help resolve the patient’s inquiry.

Understand liability claims, legal basics, medical terminology, a general knowledge of the MGB.

Network hospitals including major variations in administrative protocols as well as key industry issues.

Must provide cordial, courteous and high‑quality service to callers. Must listen attentively to patients by placing customer concerns ahead of oneself. Understand and practice concern for patients as the ultimate consumers of service.

Effectively handle all communications, which may include via work queues, correspondence, telephone and emails (MGB emails and Patient Gateway/Epic inbox messages, from patients and other departments within MGB). Utilize customer service, collections, and billing experience to gather and interpret relevant information to resolve patient account issues and complaints.

Follow through on commitments and achieve desired results. Exhibit sound judgment, obtain facts, examine options, gain support and achieve positive outcomes.

Qualifications

High school diploma or GED equivalent required.

Associate’s degree preferred.

Epic billing systems knowledge preferred.

Effective communication, organizational and problem‑solving skills required.

1‑3 years relevant experience in customer service or collections in a health care setting strongly preferred.

Alternative work experience or training in lieu of experience may be considered.

Additional Job Details

M‑F, 8:00 AM‑4:30 PM EST hours required.

Quiet, secure, stable, compliant workstation required for remote role.

Video interviews required if selected for interviews.

Teams video access required during first few weeks.

Remote Type Hybrid

Work Location 399 Revolution Drive

Scheduled Weekly Hours 40

Employee Type Regular

Work Shift Day (United States of America)

Pay Range $17.36 – $24.79/Hourly

EEO Statement Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)‑282‑7642.

Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half people‑focused, half performance‑focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

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