Patient Service Representative

Patient Service Representative

Requirements

• High School Diploma
• 2 years of experience in either Patient Access or any of the following related experience; general physician office support or billing office, insurance office, hospitality, or call center (any industry)
• Intermediate math skills acquired through classroom work or through work experience
• Typing 25 WPM
• Basic understanding of web-based systems
• Proficiency in 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 provide information on expected duration of service
• Explain the nature of work and safeguard patient information
• Hand patients off to the next area with a clear “thank you”
• Create new registrations for walk-in patients, identifying insurance coverage and collecting co-payments
• Use electronic systems to confirm coverage and resolve eligibility issues
• Screen uninsured patients for urgent status and follow charity procedures
• Assist walk-in patients and screen orders for compliance with policy
• Responsible for security authorization and precertification of services
• Notify relevant parties on uninsured cases or Third Party Liability
• Maintain knowledge of computer software programs to verify eligibility
• Identify at risk balances related to Medicare and Medicaid
• Initiate communication to patients when authorization is not obtained
• Accurately collect and analyze clinical data for prior authorization
• Ensure completion of policies for identification and notification of Primary Care Physician
• Inform relevant parties of out of network or noncovered service limitations
• Ensure accurate entry of patient demographic and insurance information
• Pre-registers and registers patients using established procedures
• Provide detailed education to patients on documents requiring signature
• Manage incoming and outgoing calls for pre-registrations
• Generate and process all required documents for registration
• Participate in departmental team building activities and in-services

Preferred Qualifications

No preferred qualifications provided.