Customer Relations Representative Job at Memorial Hermann Health System, Houston, TX 77024

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Job Description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Position is responsible for conducting moderate to complex analysis in assigned area to include monitoring of resources, evaluation of processes and presentation of historical information trends to ensure optimal departmental effectiveness. This position requires a well-developed understanding of the health insurance/health care industry, and in-depth understanding of health care data and the methods of data analysis. Job Description

Minimum Qualifications

Education: Bachelors degree in business; computer science or finance; Masters in Business or Health Management preferred

Licenses/Certifications: (None)

Experience / Knowledge / Skills
  • Three (3) years experience in healthcare planning/operations or business operations; two (2) years of data analysis
  • Facets system data analysis preferred
  • Personal computer experience should include working with Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum
  • Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas
  • Organizational skills with the ability to handle multiple tasks and/or projects at one time
  • Customer service skills with the ability to interact professionally and effectively with providers, third party payers, physicians, and staff from all departments within and outside the Company
  • Analytical and interpretation skills including departmental, utilization, financial and operations data
  • Decision-making skills with the ability to investigate and weigh alternatives and select the course of action that provides the greatest benefit to the organization
  • Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements
  • Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time
  • Problem solving skills with the ability to look for root causes and implementable, workable solutions
  • Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs
  • Must have a track record of producing work that is highly accurate, demonstrates attention to detail, and reflects well on the organization
  • Knowledgeable and compliant with all relevant laws, rules regulations and accreditation standards and requirement
  • Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of "we advance health" through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Memorial Hermann.

Principal Accountabilities
  • Leads and participates in the planning, research, analysis, development and implementation of data mining and strategic planning opportunities.
  • Develops and maintains an understanding of operations processing functions and the related data capture.
  • Collaborates with a team to drive investigating root cause, and resolving a wide variety of causes of outliers.
  • Develops and create operations analysis and implication using reports generated from internal reporting software.
  • Works with third party vendors to validate and analyze data; ensure routine & ad-hoc data requests are completed timely.
  • Maintains documentation on all queries/reports developed.
  • Implement processes, procedures and tools to formalize and streamline processes.
  • Develops and produce monthly reporting mechanisms providing feedback to management and departmental level managers to measure the Company's progress on achieving corporate goals on both a monthly and year to date basis.
  • Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable, and defined in the Memorial Hermann Health Solutions Inc department policies.
  • Communicate, collaborate and cooperate with internal and external stakeholders.
  • Adheres to all Compliance/Program Integrity requirements.
  • Complies with HIPAA Regulations
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
  • Other duties as assigned.

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