Patient Service Representative

Patient Service Representative

Requirements

• High school diploma or GED required
• Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred
• Knowledge and ability to articulate explanations of Medicare, HIPAA, and EMTALA rules and regulations and comply with updates on insurance pre-certification requirements
• Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes
• Experience with Microsoft Outlook, Word and Excel and ADT software

Responsibilities

• Greets patients arriving for their appointments
• Ensures all patient demographic and insurance information is complete and accurate
• Completes the registration process on walk-in patients, verifies and / or updates patient demographic and insurance information if changes or additions have occurred
• Verifies insurance benefits
• Obtains, calculates and collects the patients out of pocket financial liability
• Requests and collects past due and present balances or estimates due
• Follows the Financial Clearance policy for non-urgent patient services if financial clearance has not been completed or authorization has not been obtained, when appropriate
• Identifies patients in need of financial assistance and refers patients to Financial Counselor
• Performs visit closure, including but not limited to checking out patients, scheduling follow-up appointment(s), collecting additional patient responsibility (when applicable) and providing patient with appropriate documents
• Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans
• Proactively communicates issues involving customer service and process improvement opportunities to management
• Meets productivity requirements to ensure excellent service is provided to customers
• Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements
• Maintains excellent public relations with patients, families, and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information

Preferred Qualifications

• Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred