Patient Services Representative

Job Summary

Essential Functions

• Demonstrates excellent interpersonal communication skills that translate across the phone, e-mail and in person.
• Effectively and efficiently schedules patients’ initial and follow up visits as needed.
• Greets patients & visitors; Registers patients.
• Affords assistance with answering & triaging referral telephone calls; demonstrates the ability to understand and differentiate between the different types of therapy.
• Utilizes patient EMR system Collects and verifies insurance information for new and existing patients who have a change in insurance during course of care.
• Attains correct insurance benefit information from insurers.
• Communicates benefits, and potential financial responsibility to patients.
• Collections patient copays at time of service and consolidates payments on a weekly/daily basis based on location.
• Follows up with patients who have out-of-pocket costs.
• Communicates with and resolves patient questions regarding insurance and benefits.
• Obtains authorization for necessary services from insurers for patient.
• Performs accurate and timely maintenance of authorization functions, referrals and visit limit tracking in Cerner.
• Prevents disruption of service by securing necessary authorizations prior to the end date after consulting with therapist.
• Answers patient calls regarding authorization questions.
• Researches denials due to authorization or referral issues to determine cause and resolution; resubmits claims after gathering necessary information.
• Affords assistance in obtaining patient satisfaction surveys.
• Performs other duties as requested.

Documentation

• Accurately utilizes patient EMR system.
• Accurately copies record when requested.
• Accurately tracks the need for insurance reauthorizations for patients.

Team Effort

• Identifies work unit issues & implements solutions.
• Orients new staff.
• Demonstrates flexibility to help others (provide coverage, adjust work schedule to meet needs).
• Shares knowledge with others.
• Embraces change and promotes a positive work environment.
• Demonstrates management skills by prioritizing, organizing and completing job responsibilities.

Protects Customer and Organization Information

• Keeps information confidential.
• Folows Good Shepherd’s policy and procedures for release of information.
• Maintains secure medical records.
• Maintains security for the contents of the business office.

Qualifications

• High School Diploma required.
• Associate's Degree preferred.
• 1-2 years of experience in an administrative position with computer skills required.
• Prior health insurance experience preferred.
• N/A.