Customer Service Rep
Children's National Hospital
Summary
Provide single point of contact for parents in regard to billing and insurance reimbursements of physician and hospital services. Respond to high volume, complex parent inquiries regarding billing issues. Research multiple hospital and physician service billing systems to resolve customer issues. Document activities and contact in systems. Develop detailed understanding of assigned managed care contractor and payor requirements.
Job description
Patient Services
- Receive calls from parents regarding billing questions for physician and hospital services.
- Review accounts with parents and communicate any complex billing information in a way that parents can understand; work with parents to resolve billing concerns, following-up until needs are met.
- May provide information in legal matters, with appropriate authorization.
- May contact third party payors on behalf of parents to obtain additional information.
- May provide further account itemization to parents; interpret EOB letters for parents.
- Integrate information from multiple systems to develop responses to parents' concerns.
Billing Issues
- Develop detailed knowledge of internal billing systems to research billing inquiries for both physician and hospital services.
- Identify source of any issue and the resources required to resolve in a timely manner; refer unresolved issues to manager.
- Adjust overpayments and posting errors to accounts.
- Within identified parameters, write-off account balances; recommend and refer larger write-offs to manager for approval, provide supporting documentation.
- Document actions in system including research findings, write-offs, documentation sent, documentation requested etc.
- May add insurance information to systems.
Safety
- Speak up when team members appear to exhibit unsafe behavior or performance.
- Continuously validate and verify information needed for decision making or documentation.
- Stop in the face of uncertainty and take time to resolve the situation.
- Demonstrate accurate, clear and timely verbal and written communication.
- Actively promote safety for patients, families, visitors and co-workers.
- Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance.
Requirements
- High School Diploma or GED (Required)
- 3-5 years medical business office experience (Required)
- Strong analytical skills to interpret billing information
- Ability to communicate effectively with parents and third-party payors
- Customer service experience
- Knowledge of insurance reimbursement and billing processes
- Experience with account reconciliation and data entry
- Understanding of managed care and payor requirements
- Ability to interpret EOB letters
- Problem solving and conflict resolution skills
Company overview
Children's National Hospital is a premier pediatric healthcare institution located in Washington, D.C., recognized as one of the top children's hospitals in the United States. Founded in 1870, it serves as the region's primary pediatric academic medical center, providing comprehensive care across all pediatric specialties. The hospital operates a 323-bed facility and offers advanced medical services including neonatal intensive care, pediatric surgery, oncology, cardiology, and neurology. As an academic medical center affiliated with the George Washington University School of Medicine and Health Sciences, Children's National is deeply involved in pediatric research, medical education, and clinical innovation. The institution is particularly renowned for its Sheikh Zayed Institute for Pediatric Surgical Innovation and its leadership in pediatric genomics and precision medicine. Children's National consistently ranks among the top pediatric hospitals nationally, with specialties in cancer, cardiology, neurology, and neonatology receiving particular recognition for excellence in patient care and outcomes.