Patient Service Representative II AHWFB

Department: Surgery - Plastic and Reconstruction
Status: Full time, benefits eligible
Hours per week: 40

Schedule

• Monday - Friday, 8:00 AM to 5:00 PM

Pay

Pay range: $21.85 - $32.80 per hour

Requirements

• High school diploma or equivalent and three years of experience working in a customer service role within a fast-paced, high-volume environment (calls or in-person requests); or an equivalent combination of education and experience

Responsibilities

• Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems
• Pre-register all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures
• Verify insurance coverage and obtain authorization for all services requiring pre-certification
• Process internal and outgoing referrals as needed, per department procedures
• Perform clerical functions including answering phones, taking messages, chart processing, faxing, and scanning
• Collect and process upfront deposits or set up payment arrangements as required
• Screen patients for Medicaid, Affordable Care Act, or hospital-sponsored financial programs and provide appropriate documentation and referral
• Assist other team members where necessary
• Adhere to department policies and procedures related to verification of eligibility, benefits, pre-authorization requirements, available payment options, financial counseling, and other identified financial clearance duties
• Complete assigned registration functions within multi-specialty clinic and/or emergency department, including claim edit work queues, pre-certifications, and authorizations
• Sequence multiple physician visits and complete registration activities within multiple registration platforms
• Assist team with escalated issues, train other team members as needed, and serve as a subject matter expert
• Participate in departmental performance improvement initiatives
• Perform other duties as assigned or requested by supervisor or manager, such as acting as backup in other departments
• Understand and maintain operational knowledge of Medicare and other state and federal government payer compliance requirements for the population served

Skills & Qualifications

• EPIC Cadence experience preferred
• Expert knowledge of patient access services and the overall effect on the revenue cycle
• Thorough understanding of commercial and government insurance plans, payer networks, government resources, and medical terminology
• Understand and maintain operational knowledge of Medicare and other state and federal government payer compliance requirements
• Demonstrated proficiency in communicating effectively with customers and simplifying complex information
• Demonstrated ability in critical thinking and adhering to compliance protocols
• Demonstrated ability to handle escalated issues, train/mentor other team members, and serve as a subject matter expert
• Ability to navigate Internet Explorer and Microsoft Office Suite applications
• Experience working in a role requiring prioritization of multiple critical priorities while ensuring quality and achievement of performance metrics
• Demonstrated ability to meet or exceed performance metrics
• Ability to handle sensitive information and maintain HIPAA compliance

Work Environment

• Clean, indoor environment
• Minimal travel to clinic locations where assistance is needed

Physical Requirements

• Standing: 0%
• Walking: 35%
• Sitting: 65%
• Bending: Occasionally
• Reaching with arms: Occasionally
• Finger and hand dexterity: Frequently
• Talking: Frequently
• Hearing: Frequently
• Seeing: Frequently
• Lifting, carrying, pushing, and/or pulling up to 20 lbs. maximum

Benefits

• Paid Time Off programs
• Health and welfare benefits (medical, dental, vision, life, short- and long-term disability)
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program
• Base compensation within the listed pay range based on qualifications, skills, relevant experience, and/or training
• Premium pay such as shift or on-call pay based on the job
• Incentive pay for select positions
• Opportunity for annual increases based on performance