Customer Service Rep

In 2020, united in a fierce commitment to deliver the highest quality care and exceptional patient experience, Virginia Mason and CHI Franciscan Health came together as natural partners to build a new health system centered around the patient: Virginia Mason Franciscan Health. Our combined system builds upon the scale and expertise of our nearly 300 sites of care, including 11 hospitals and nearly 5,000 physicians and providers. Together, we are empowered to make an even greater impact on the health and well-being of our communities.

CHI Franciscan and Virginia Mason are now united to build the future of patient-centered care across the Pacific Northwest. That means a seamlessly connected system offering quality care close to home. From basic health needs to the most complex, highly specialized care, our patients can count on us to meet their needs with convenient access to the region’s most prestigious experts and innovative treatments and technologies. 

While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that may include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility, and more!

Job Summary
Provides customer service activities in support of the Laboratory department, and is able to quickly discern problems or recognize discrepancies in a fast-paced department. Work includes responding to telephone inquiries for lab testing information and results, and troubleshooting related issues. Completes additional testing requests, collects and distributes patient demographic information using multiple computer systems, including performing significant amounts of data entry for technical billing and crediting. Provides problem resolution for billing and crediting in Lab Information System (LIS) and electronic medical record (EMR), and is a point of contact for complex ordering procedures. Work requires strong customer service skills, teamwork, and knowledge of lab operations processing workflow.

Essential Job Function
Provides customer service and responds to all inquiries from internal and external sources including providing test results, ordering additional testing, report distribution, fax reporting, specimen collection requirements, and taking verbal orders.
• Validates patient identity according to department standards
• Greet, identify, and registers patients; collects demographic information and selects appropriate accounts and codes in accordance with lab protocol.
• Investigates and corrects returned mail for provider address issues; updates LIS and resends results.
• Adheres to all HIPAA and compliance standards for all interactions including releasing results to patients and providers.
• Tracks and responds to customer specific reporting requirements i.e., call back, fax, consult copies per department protocol.
• Organize and distribute LIS reports for delivery to the ordering provider.
• Responding to pricing inquiries from PacLab patients.
• Assesses sample stability for client add-ons. Orders testing as requested.
• May order office supplies
Documents results in all required applications to ensure all lab stakeholders have access to required information to support changes in testing, provider, billing, account selection, or result correction processes.
• May enter results of specialty lab testing into LIS and distributes hard copies.
• May perform restore functions in LIS for purged patient encounters.
Receives and maintains paperwork according to department standards. Distributes to vendor as supportive documentation for billing. Performs result entry and error corrections in LIS.
• Scans one-time and standing orders for electronic viewing at all sites.
• Receives and sorts faxes and distributes contained work to other team members.
• May reconcile referral lab billing for appropriate charges.

Responds and/or investigates issues related to orders, revenue integrity, patient identity, testing, new client set-up requests, and customer service inquiries utilizing all computer applications. Follows up and documents all actions related to each inquiry.
• Review follow up order. Prioritize issues and consolidate call backs to providers. Initiates follow up resolution based on provider input.
• Enters CRM data for quality purposes per departmental standards.
• Tracks, monitors, and initiates corrective action to assure pending tests ordered are completed.
• May assign accounts in LIS for new drug collection clients; updates drug protocol database.
• As directed from LIS or HIM, may perform account combine activities.
Enter and correct results, identifies codes and pricing for billing. Performs crediting in response to identified errors/issues, and enters supporting documentation for all transactions. Utilizes all EMR documentation to support billing.
• Reviews daily patient and client billing via LIS/EMR error queues and corrects identified errors.
• Reconciles daily bill for reflexive orders from reference lab and enter billing corrections as required.
• Orders miscellaneous billing in LIS utilizing proper diagnosis codes and pricing obtained per department protocol.
• Performs crediting activities per department protocol to ensure accurate billing.
• Identifies and corrects charges that may be suspended.
• Pulls and evaluates the client bills for Long term care; corrects charges as required relating to trip and draw fees.
• Corrects date of service ordering issues identified in the work queue. Finds and reassigns charges from invalid to valid Epic accounts. Places order in PacLab as needed.
• Applies appropriate modifiers to claims in the claim editing work queue; able to investigate documentation to validate charges.
Creates patient accounts, transcribes and/or releases orders in the electronic medical record, according to departmental standards.
• Registers patients for laboratory services to include outreach and hospital outpatient departments in LIS or Electronic Medical Record (EMR).
• Identifies patient orders from Hospital Outpatient Departments (HOD).
• Performs Silent Walk-in procedure.
• Transcribes orders and create accounts for lab work to be performed.
Cultural Sensitivity and Competence: Demonstrates proper use of communication tools/materials for effective communication and understands how the culture(s) of patient populations can affect communication, collaboration and the provision of care, treatment and services. Patient Population Served: Demonstrates knowledge and proper skills associated with the department’s defined specific populations served.
Performs related duties as required.

Education/Work Experience Requirements
High school diploma (or GED equivalent) and two years of related clinical laboratory work experience that demonstrates the attainment of the requisite job knowledge skills/abilities required. Strong customer skills required

Licensure/Certification
None