Representative, Patient Solutions - Healthcare RCM

Hey there! We’re Acclara.

As a remote-first workforce with team members in all 50 states, we’re a unique group of strategists, technologists, and service providers—all united in serving our partners to deliver the best care to their patients, helping build even healthier communities for us all to live and work in.

We bring our one-of-a-kind selves to work each day, and we welcome (and want) you to do the same. Coffee connoisseurs, moms and dads, runners, animal lovers, adventurists—the list goes on—we all came to make a difference, and we stay because we’ve found a place where we don’t have to do it alone.

Our team’s work is fueled by our CORE values of Commitment, Outcomes, Respect, and Empowerment. They’re the “how” behind what we do, guiding our actions as we aim to change the way technology and services come together.

The Role

The Patient Solutions Representative is responsible for delivering a high-quality patient experience through inbound and outbound calls assisting patients, their representatives and/or payers with inquiries and concerns in a confidential and professional manner with a focus on first-call resolution when possible. Identify type of assistance needed such as updating information, making a payment, payment plan arrangements and insurance related questions to ensure proper account resolution.

What You’ll Do

• Deliver a high-quality patient experience thought inbound and outbound customer service calls. Determine assistance needed (i.e., benefit and eligibility, billing and payments, authorization or treatment, EOBs, etc.) and take appropriate action on the related accounts in a timely manner while upholding a high level of professionalism and accuracy.
• Review patient statements/EOBs, balances, identify unapplied adjustments
• Ask appropriate questions and listen actively to identify specific concerns or issues while documenting all required information in computer systems in a clear and concise manner
• Provide one call resolution to patient inquires whenever possible and perform timely follow up
• Review incoming correspondence, taking appropriate and timely action by updating the respective accounts
• May review the Payment Plan, No Statement, Special Handling, Expired, and Bankruptcy tickler queues designated for follow up, taking appropriate action
• Provide patient education regarding how to understand their Explanation of Benefits (EOB)
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
• Always comply with HIPAA and other compliance requirements to protect patient confidentiality
• May be required to identify contractual and administrative adjustments
• Effectively navigate several computer applications during and after phone calls, document all actions taken in appropriate company and/or client systems
• Adhere to benchmarks and strive for continuous improvement on customer service metrics such as: adherence to schedule, call abandonment rate, speed to answer, talk time, wrap (documentation) time, etc.
• Other duties as assigned

What We’re Looking For

• High school diploma or GED
• 1-year previous work experience as a patient services/customer service representative
• Understanding of patient/customer service and insurance follow-up concepts (i.e., billing, collections, managed care, Medicare, Medicaid, and Commercial Practices), and well-developed interpersonal skills
• Basic knowledge of health care industry terms
• Strong problem-solving and critical thinking skills to research information using available resources.
• Ability to be flexible in a fast-paced environment and adapt with change
• Ability to perform at a high level of productivity and quality
• Detail oriented with the capacity to maintain a high level of accuracy
• Excellent written and verbal communication skills
• Ability to navigate through multiple software and computer applications
• Ability to perform under pressure while maintaining a calm and professional manner
• Basic math skills to be able to calculate discounts, payment plan arrangements, validate contractual and out of picket patient liability

Preferred Qualifications:

• 1-year experience in a call center environment (healthcare experience a plus)
• Bilingual English/Spanish

How We Take Care of Our Team Members

• Remote-first workplace, with opportunities to work on-site in certain locations
• Comprehensive medical, dental, and vision coverage
• Parental leave
• 401K with company match
• Company-paid life insurance, short-term disability, and long-term disability
• Paid time off and holidays

Pay Range: $16.33 - $19.00

This compensation range is a reasonable estimate that extends from the lowest to the highest pay Acclara in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Acclara may ultimately pay more or less than the posted range as permitted by law.

Diversity, Equity, and Inclusion Matter

At Acclara, you’re invited to bring more of yourself to work—not less. Your background, your culture, and your personal experiences are all important pieces of the authentic you, and we honor that. Connection is created when we show up.

Acclara, an R1 company, is dedicated to the fundamentals of equal employment opportunity. Acclara’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, Acclara is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you need reasonable accommodation due to a disability for any part of the interview process, please contact careers@acclara.com.

Visa Sponsorship is not available at this time.

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