Patient Account Specialist

You’re more valuable than ever – And that’s just how we’ll make you feel.**Summary**The Patient Account Specialist is responsible for taking all inbound phone calls, researching customer issues, collecting customer information, collecting payments from customers, responding to all customer inquiries via fax/email/calls, and processing all correspondence.**Qualifications****Education Required:*** High School Diploma or GED**Work Experience Required:*** 1-2 years of Customer Service experience**Preferred Qualifications, Education, Licenses, Certifications, Experience, etc.:*** 2 years Medical Billing experience* CPAR – Certified Patient Account Representative* Associate’s degree in business administration or related field* Medical insurance billing and claims processing* Epic or eClinicalWorks experience* Bilingual**Knowledge, Skills, and Abilities*** This role involves interaction and collaboration with other departments and requires excellent judgment and interpersonal skills.* Understanding of basic medical terminology.* Highly experienced in Microsoft Excel and Word for data entry, reporting, and documentation.* Strong working knowledge of medical billing codes such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) coding for accurate billing and claims processing.* Exceptional phone and communication skills with the ability to interact effectively across departments and with customers.* Ability to organize and prioritize tasks efficiently in a fast-paced environment.* Proficient in computer systems and mathematical calculations related to customer accounts and billing.* Ability to maintain strict customer confidentiality in compliance with HIPAA and company policies.* Demonstrated ability to follow through with customer inquiries and resolve issues with professionalism and sound judgment.* Ability to calculate deductibles and co-insurance accurately.* Ability to read and interpret Explanation of Benefits (EOBs).**Essential Duties and Responsibilities*** Maintain consistent daily communication with Team Leaders and Section Leaders.* Deliver high-level customer service to Accounts Receivable Specialists, payors, and urgent care centers.* Provide exceptional service to customers, ensuring a positive and professional experience.* Manage each customer inquiry through resolution, collaborating with internal teams as needed and ensuring timely follow-up.* Responsible for collecting unpaid customer balances and assisting with credit card payments.* Accurately update and maintain customer demographic and insurance information.* Address service-related issues professionally when interacting with customers, guests, physicians, and team members.* Communicate clearly with customers regarding medical and financial matters via phone, email, or other communication channels.* Serve as an effective extension of GoHealth centers, supporting their mission and values.* Share relevant information with team members to support collaboration and continuity of care.* Assist colleagues with tasks and responsibilities when time permits.* Accurately calculate customer deductibles and co-insurance amounts based on insurance plan details and service charges.* Review and interpret Explanation of Benefits (EOBs) from insurance carriers to ensure proper account handling and customer communication.* Maintain composure and focus while managing multiple tasks and customer interactions in a high-pressure environment.* Demonstrate flexibility and open-mindedness when approaching problem-solving and adapting to changing workflows or priorities.**GoHealth Core Values**GoHealth’s Core Values, listed below, are essential functions of this position:* **Collaboration:** Takes ownership for collectively establishing productive partnerships and relationships and seek to gain joint understanding of priorities and objectives so that the greater good of the organization and those we serve is always at the forefront.* **Innovation:** Consistently uses good judgment, applying creativity to overcome obstacles and increasing effectiveness and efficiency through process and other forms of innovation.* **Diversity & Inclusion: Fosters** diversity and inclusion, to be able to better understand team members, our customers and partners.

Engages the strengths and talents of each GoHealth team member, creating an environment of involvement, respect and connection where the richness of ideas, backgrounds and perspectives are harnessed.* **Courage & Integrity:** Models and practices the highest ethical and professional standards; demonstrates pride and personal interest in our customers, partners and fellow team members, deeply engaging in the business. Makes decisions, with a focus on doing the right thing; treats team members, our customers, partners and vendors with dignity, consideration, open-mindedness and respect.* **Accountability:** Always shows initiative, demonstrates a bias to action and gets things done. Actively accepts responsibility for diverse roles, obligations and actions that positively influence patientand customer outcomes, our partnerships and the healthcare needs of our communities.**Physical Requirements*** **Office Environment:** Tasks may be conducted within a climate-controlled office setting.* **Internet Requirements for Remote Call Center Team Members:** To ensure optimal and a seamless customer experience, the following internet connection requirements must be met by all the call center team members working from home.Connection Type:* A hardwired (Ethernet) connection is mandatory to ensure stability and reliability.* Wireless (Wi-Fi) connections are not permitted for work purposes due to potential signal fluctuations, interference, and latency issues.Minimum Internet Speed:* Download speed: At least 100 Mbps* Upload speed: At least 10 Mbps* These speeds are required to handle voice, video calls, and data transmission simultaneously.Latency (Ping):* The network latency must not exceed 100ms to avoid delays in communication.Internet Service Provider (ISP):* The team member must subscribe to a reliable ISP that provides high-speed broadband services (e.g., Fiber Optic, Cable).* DSL, satellite, or mobile hotspot connections are not recommended due to higher latency and potential service disruption.Backup Internet Connection (Optional but Recommended):* Team members should have a backup internet source (e.g., secondary broadband or mobile data) in case of primary service disruption.Testing and Compliance:* Team members are required to perform a speed test using a reliable tool (such as Speedtest by Ookla) before the start of their shifts.* A record of compliance may be requested periodically to ensure adherence to these guidelines.Equipment:* Team members are responsible for ensuring that they have the appropriate modem, router, and Ethernet cable to meet these standards.* The router should be placed in a location that minimizes interference and maximizes the signal strength to the modem.* **Physical Activity:** The role may require the ability to lift, carry, push, or pull materials, supplies, and equipment (up to 10 lbs.) Duties typically involve a combination of sitting, standing, and walking, with frequent changes in position.* **Travel:** Travel may be required, including travel between facility locations, remote facilities, and out-of-town destinations as needed. 0-10%* **Safety Equipment:** May require the use of safety equipment for infection prevention.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_*Note: This Job Description is not inclusive of all the duties of the position. You may be asked by Leaders to perform other duties. Leadership may revise this job description #J-18808-Ljbffr