ONE CALL RESOLUTION SPECIALIST

MAY REQUIRE TO COME IN THE OFFICE OCCASIONALLY OTHERWISE REMOTE.

FLEX, FLOAT, VARIES, WEEKENDS, HOLIDAYS (MUST HAVE OPEN AVAILABLITY TO WORK ANY SHIFT)

80 HOURS PER PAY PERIOD

The One Call Resolution Specialist supports the Premier Health mission, vision, and values by serving as the primary contact for scheduling patient procedures and resolving the financial aspects related to those services. This role combines the responsibilities of outpatient procedure scheduling with financial clearance functions ensuring accuracy in patient demographics, insurance, and billing details. The One Call Resolution Specialist will be knowledgeable of self-pay and financial assistance policies, with the expectation to discuss accounts with patients and third parties who are responsible for payment.

This position plays a key role in the Revenue Cycle process by coordinating pre-service activities such as appointment scheduling, insurance verification, financial screening, and patient education regarding financial responsibilities. The One Call Resolution Specialist is responsible for providing outstanding customer service while performing all duties in a courteous, respectful, and professional manner. A high level of integrity, confidentiality, and judgment is essential.

One Call Resolution Specialists must communicate effectively with patients, internal and external departments, third-party payers, and vendors through various channels such as phone, MyChart, email, and written correspondence. This position will hold quality customer satisfaction as a top priority.

The One Call Resolution Specialist shares fiscal responsibility with other Revenue Cycle departments to complete timely financial clearance on accounts, collect on accounts, reduce bad debt, advise patients, and obtain the necessary information to process applications for all available financial assistance programs. This includes evaluating patient eligibility for Medicaid, state and hospital-sponsored charity care programs, and other available funding sources. The One Call Resolution Specialist position will help patients determine a plan for resolution of their financial responsibilities.

The One Call Resolution Specialist is responsible for posting billing and collection transactions, ensuring appropriate self-pay liability is applied to accounts up to and including the final disposition of the balance, and calculating and collecting the patients’ estimated balances at pre-service or at the point of service. The One Call Resolution Specialist must possess the ability to use critical thinking skills to provide the best resolution based upon the patient’s individual situation.

One Call Resolution Specialists collaborate with other departments within the hospital and with outside vendors as necessary. They utilize financial systems to document data, and must demonstrate integrity, good judgment, and trust to ensure patient confidentiality is maintained at all times.

Education

Minimum Level of Education Required: High School completion / GED

Preferred educational qualifications: Associates Degree preferred in related field.

Position specific testing requirement: Must be proficient with Windows-based computer technology. Proficient in managing professional communication through email and utilizing Microsoft office 365 tools (outlook, word, excel, teams, etc.) for daily operations, documentation, and collaboration

Licensure/Certification/Registration

Medical Terminology and coding knowledge preferred.

Experience

Minimum Level of Experience Required: 3 - 5 years of job related experience

Preferred experience: Experience working with the public is required. Courses/workshops in compliance, medical self-pay accounts receivable management, Medicaid, medical billing preferred. Familiarity with statutes and regulations regarding self-pay collections practices and financial assistance is preferred. Associate’s degree in healthcare or business can be substituted for two years of experience.

Other experience requirements: Overall knowledge of patient registration, third party collections, verification of insurance benefits, Medicaid and other government programs, hospital billing and/or managed care contracts is required. Must have 2 years of customer service experience with 3 + years of recent financial assistance, billing, insurance verification, or self-pay accounts receivable management experience in a healthcare/medical setting or financial institution setting with oversight of functions such as processes patient payment plans. Must possess good math skills and pass a skills test which includes calculating co-pays and deductibles

ONE CALL RESOLUTION SPECIALIST-REMOTE