Patient Service Rep 1

Responsibilities

• Greets patients arriving for their appointments.
• Monitors patient flow to ensure patients are cared for in the most efficient and courte manner.
• 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.
• Obtains, calculates, and collects the patient’s 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.
• Identifies patients in need of financial assistance and refers them to the Financial Counselor.
• Performs visit closure, including 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 for 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 a 98% accuracy rate and established department productivity measurements.
• Maintains excellent public relations with patients, families, and clinical staff, demonstrating a willingness and ability to work collaboratively with others for concise and timely flow of information.

Requirements

• High school diploma or GED required.
• Patient access (scheduling, registration, and financial clearance), insurance verification, billing, or certified medical assistant experience preferred.

Skills

• Ability to identify and understand issues and problems; examines data and draws logical conclusions based on available information.
• Knowledge and ability to articulate explanations of Medicare, HIPAA, and EMTALA rules and regulations, and comply with updates on insurance pre-certification requirements.
• Mathematical aptitude, effective oral and written communication skills, and critical thinking skills.
• Understanding of basic human anatomy, medical terminology, and procedures for application in patient referral, pre-certification, and authorization processes.
• Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversations.
• Ability to handle sensitive and confidential information according to internal policies.
• Experience with Microsoft Outlook, Word, Excel, and ADT software.
• Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages.
• Must be able to work with minimal supervision, problem-solve in a high-profile and high-stress area, and interact positively with all internal and external customers while possessing the ability to determine priority of work.

Physical Requirements and Working Conditions

• Exposed to a normal office environment.
• Must be able to sit the majority of the workday.
• Occasionally lifts up to 10 lbs.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.