Customer Service Representative I
Mass General Brigham, Somerville, MA, United States
Mass General Brigham Incorporated is a not-for-profit organization that supports patient care, research, teaching and community service. We believe high-performing teams drive groundbreaking medical discoveries and invite applicants to join our mission.
Job Summary Reporting to and working under the general direction of the Manager, the PBS team reviews and resolves guarantor account balances. Contact with guarantors can be inbound or outbound through phone, written correspondence, e‑mail or secure Epic in‑basket requests. Primary focus is timely responses to guarantor inquiries, using the method that originally contacted PBS.
Responsibilities
Respond to patient/guarantor/customer concerns covering payer denials, coding accuracy, secondary billing, Coordination of Benefits, co‑payment verification, update demographics and insurance information, and fiscal registrations.
Apply Credit & Collection Policy and Financial Assistance Policy, informing patients of all assistance when arranging payments.
Provide timely, professional, and accurate account review, analysis and resolution of patient inquiries, resolving issues during the call whenever possible, verifying fiscal and demographic information, and updating billing systems.
Obtain information and perform actions on accounts in Epic (HB & PB Resolute) and selected HB accounts (TRAC & QUIC); use supporting systems (LDA, OnBase, NEHEN, payer websites, SharePoint) to identify root causes.
Understand liability claims, legal basics, medical terminology and MGB network hospitals’ administrative protocols.
Provide courteous and high‑quality service to callers, listening attentively to patient concerns.
Effectively handle all communications via Work Queues, correspondence, telephone and e‑mail (MGB emails, Patient Gateway/Epic Inbox messages).
Document every account accessed with clear concise notes.
Ensure accurate patient billing by reviewing account history, third‑party billing activity and payment analysis; seek assistance from Coding, Third‑Party Billing, Revenue Control and Group Practice Billing Managers when needed.
Identify root causes of guarantor/patient inquiries, report findings to management and follow up to ensure resolution.
Submit patient credit balances to appropriate parties for refund action after verifying the reason for the credit.
Communicate clearly and concisely orally and in writing, adhere to recording, storage and handling procedures, and preserve confidentiality per MGB HIPAA policy.
Demonstrate MGB values such as integrity, honesty, confidentiality, positive attitude, teamwork, collaboration, and commitment to ethical conduct.
Maintain high standards of professional conduct, comply with MGB Patient Billing Solution policies, attend required training, and arrive prepared on time.
Meet specific expectations: answer at least 40–50 calls per day, provide weekly account lists to supervisor, resolve at least 80 % of patient issues independently, pass routine quality assurance reviews ≥90 %, and perform other duties as assigned.
Qualifications
High School diploma or GED equivalent required.
Associate’s degree preferred but not required.
Epic billing systems knowledge preferred.
Effective communication, organizational and problem‑solving skills required.
1–3 years of relevant experience in customer service or collections in a health‑care setting strongly desirable.
Alternative work experience or training may be considered in lieu of experience.
Additional Job Details
Monday–Friday, Eastern 8:00 AM–4:30 PM EST required.
Remote role with onsite requirements as needed in Somerville, MA for meetings.
Remote Type Remote
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $17.71 – $25.28 / 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. Disabled applicants requiring accommodation may contact Human Resources at (857) 282‑7642.
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Job Summary Reporting to and working under the general direction of the Manager, the PBS team reviews and resolves guarantor account balances. Contact with guarantors can be inbound or outbound through phone, written correspondence, e‑mail or secure Epic in‑basket requests. Primary focus is timely responses to guarantor inquiries, using the method that originally contacted PBS.
Responsibilities
Respond to patient/guarantor/customer concerns covering payer denials, coding accuracy, secondary billing, Coordination of Benefits, co‑payment verification, update demographics and insurance information, and fiscal registrations.
Apply Credit & Collection Policy and Financial Assistance Policy, informing patients of all assistance when arranging payments.
Provide timely, professional, and accurate account review, analysis and resolution of patient inquiries, resolving issues during the call whenever possible, verifying fiscal and demographic information, and updating billing systems.
Obtain information and perform actions on accounts in Epic (HB & PB Resolute) and selected HB accounts (TRAC & QUIC); use supporting systems (LDA, OnBase, NEHEN, payer websites, SharePoint) to identify root causes.
Understand liability claims, legal basics, medical terminology and MGB network hospitals’ administrative protocols.
Provide courteous and high‑quality service to callers, listening attentively to patient concerns.
Effectively handle all communications via Work Queues, correspondence, telephone and e‑mail (MGB emails, Patient Gateway/Epic Inbox messages).
Document every account accessed with clear concise notes.
Ensure accurate patient billing by reviewing account history, third‑party billing activity and payment analysis; seek assistance from Coding, Third‑Party Billing, Revenue Control and Group Practice Billing Managers when needed.
Identify root causes of guarantor/patient inquiries, report findings to management and follow up to ensure resolution.
Submit patient credit balances to appropriate parties for refund action after verifying the reason for the credit.
Communicate clearly and concisely orally and in writing, adhere to recording, storage and handling procedures, and preserve confidentiality per MGB HIPAA policy.
Demonstrate MGB values such as integrity, honesty, confidentiality, positive attitude, teamwork, collaboration, and commitment to ethical conduct.
Maintain high standards of professional conduct, comply with MGB Patient Billing Solution policies, attend required training, and arrive prepared on time.
Meet specific expectations: answer at least 40–50 calls per day, provide weekly account lists to supervisor, resolve at least 80 % of patient issues independently, pass routine quality assurance reviews ≥90 %, and perform other duties as assigned.
Qualifications
High School diploma or GED equivalent required.
Associate’s degree preferred but not required.
Epic billing systems knowledge preferred.
Effective communication, organizational and problem‑solving skills required.
1–3 years of relevant experience in customer service or collections in a health‑care setting strongly desirable.
Alternative work experience or training may be considered in lieu of experience.
Additional Job Details
Monday–Friday, Eastern 8:00 AM–4:30 PM EST required.
Remote role with onsite requirements as needed in Somerville, MA for meetings.
Remote Type Remote
Work Location 399 Revolution Drive
Scheduled Weekly Hours 40
Employee Type Regular
Work Shift Day (United States of America)
Pay Range $17.71 – $25.28 / 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. Disabled applicants requiring accommodation may contact Human Resources at (857) 282‑7642.
#J-18808-Ljbffr