Patient Service Representative

Patient Service Representative

Requirements

• High School Diploma
• 2 years of experience in either Patient Access or related experience (general physician office support, billing office, insurance office, hospitality, or call center)
• Intermediate math skills acquired through classroom work or work experience
• Typing 25 WPM
• Basic understanding of web-based systems
• Proficiency in data entry
• Ability to prioritize and organize workload
• Sophisticated interviewing, communication and negotiation skills
• Independent decision making
• Ability to work hours that vary based on needs of the organization including evenings, weekends and holidays
• Ability to work as a team member
• Must be able to sit, stand, walk, lift, carry, squat, and bend frequently as well as twist, rotate, and kneel occasionally throughout the workday
• Must be able to push/pull up to 50 lbs. with assistance
• Must have functional speech and hearing
• Must be able to use hands with fine motor skills for keyboard data entry

Responsibilities

• Perform all job duties in a way that conforms to customer service philosophy and consistent with “AIDET” standards
• Greet and acknowledge all patients and family members in a welcoming and prompt manner
• Introduce the patient to services and explain what they can expect while under care
• Provide information on likely time spent in service area including registration and clinical service
• Explain the nature of work and how demographic, socio-economic, and financial information is safeguarded
• Hand patients off to the next area with a clear “thank you”
• Identify insurance coverage and benefits for walk-in patients
• Collect appropriate out of pocket expenses in accordance with policy
• Use electronic systems to confirm coverage while patient is present
• Screen uninsured patients for urgent status cases and follow charity procedure
• Screen orders for compliance with policy when assisting walk-in patients
• Responsible for security authorization and precertification of inpatient and outpatient services
• Notify Financial Counseling, physicians, Care Coordinators, and Utilization Management on cases where patients are uninsured
• Maintain knowledge of all stand-alone computer software programs to verify eligibility
• Identify at risk balances related to Medicare and Medicaid and communicate to relevant parties
• Initiate communication to patients when authorization is not obtained and explain potential financial impact
• Accurately collect and analyze clinical data in support of prior authorization and precertification
• Ensure accurate entry of patient demographic and insurance information in the ADT system
• Pre-register and register patients using established procedures
• Provide detailed education to patients on documents requiring signature during registration
• Manage incoming and outgoing calls to complete pre-registrations
• Generate, assemble and process all required documents for completion of each registration
• Participate in departmental team building activities and in-services and other miscellaneous duties as assigned

Preferred Qualifications

No preferred qualifications provided.