**Join arenaflex, a leading healthcare organization, in shaping the future of patient care and billing excellence. As a Senior Customer Experience Representative, you will play a vital role in ensuring seamless interactions between patients, providers, and payers. If you're passionate about delivering exceptional customer service, possess a keen eye for detail, and thrive in a dynamic environment, we invite you to explore this exciting opportunity.**
**About arenaflex**
arenaflex is a community-driven healthcare organization that puts people at the heart of everything we do. Our mission is to bring the best possible care to every person and parish in Louisiana and beyond. We celebrate authenticity, originality, equity, inclusion, and a little "come on in" attitude, which is the foundation of our culture of everyday extraordinary. Our people make health happen, and we're committed to creating a work environment that fosters growth, innovation, and compassion.
**Your Everyday**
As a Senior Customer Experience Representative, you will be responsible for ensuring the timely and accurate processing of professional claims, serving as a mentor and resource to fellow billing staff, and completing special projects as needed. Your daily tasks will include:
* Maintaining responsibility of the timely submission of all professional claims assigned
* Working daily electronic billing file and submitting insurance claims to third-party payers; reviewing daily edit reports from the professional billing system and making necessary corrections to allow electronic submission
* Reviewing error reports from electronic payers; identifying errors and making appropriate corrections to ensure accurate claim submission
* Monitoring claim rejections for trends and issues and reporting findings to supervisor
* Preparing and submitting manual insurance claims to third-party payers who do not accept electronic claims or who require special handling
* Coordinating medical record requests as needed
* Documenting billing activity on the patient account; ensuring compliance with all state and federal billing regulations and reporting any suspected compliance issues to the Billing Manager and/or Supervisor
* Working with supervision, management, and the patient accounting staff to improve processes, increase accuracy, create efficiencies, and achieve the overall goals of the department
* Observing best practice processes in billing, follow-up, and customer service activities
* Participating in staff training that aligns with recognized improvement opportunities and increasing understanding of Medicare/Medicaid requirements as well as general billing and follow-up processes
* Acting in accordance with arenaflex's mission and values, while serving as a role model for ethical behavior
* Adhering to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines)
**The Must-Haves**
* EDUCATION/EXPERIENCE QUALIFICATIONS:
+ Required: High School Diploma/GED or equivalent OR 2 years of work experience
+ Preferred: 3 years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management
* LICENSES AND CERTIFICATIONS:
+ Certification in billing and/or coding
* KNOWLEDGE, SKILLS, AND ABILITIES:
+ Ability to pass basic computer skills test and system level training
+ Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes
+ Demonstrates knowledge of:
- Hospital and professional billing processes and reimbursement
- Third-party contracting
- Insurance protocols, delay tactics, systems, and workflows
- ERISA guidelines for denials and appeals
- Regulations related to denials and appeals
+ Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
+ Possesses efficient time-management skills and proven ability to multitask under tight deadlines
+ Demonstrates excellent customer service skills
+ Effective writing and communication skills
+ Strong comfort level with computer systems
**Work Shift**
Days (United States of America)
**Your Extras**
* Deliver healthcare with heart
* Give people a reason to smile
* Put a little love in your work
* Be honest and real, but with compassion
* Bring some lagniappe into everything you do
* Forget one-size-fits-all, think one-of-a-kind care
* See opportunities, not problems – it's all about perspective
* Cheerlead ideas, differences, and each other
* Love what makes you, you – because we do
**You are welcome here**
arenaflex is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.
**The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. arenaflex reserves the right to amend and change responsibilities to meet organizational needs as necessary.**
**Simple things make the difference**
1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information.
2. To ensure quality care and service, we may use information on your application to verify your previous employment and background.
3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed.
4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.
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