Patient Services Representative

Responsibilities

• Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner.
• Sregisters patients in the system as necessary.
• Collections and reviews all patient insurance information and completes insurance forms.
• Collections and reviews all patient insurance information and completes insurance forms.
• Collects co-pays, deductibles and other out of pocket amounts at the time of visit.
• Confirms patient insurance verification and eligibility.
• Obtains pre-authorization of services and/or referrals.
• Assesses patient financial requirements and advises patients and families on insurance benefits, co-pays and financial obligations.
• Posts line items and adjustments to patient accounts.
• Balances receipts, reconciles daily work batches and prepares audit trail.
• Prepares deposits for bank as needed.
• Reviews Explanation of Benefits (EOB) for consistency.
• SUBMIT FILES AND PROCESS ALL CLAIMS FOR PAYMENT.
• RESEARCHES AND RESOLVES CLAIM DELAY ISSUES.
• RESOLVES PATIENT QUESTIONS AND COMPLAINTS REGARDING INSURANCE BILLING AND ADJUSTS ACCOUNTS AS NECESSARY.
• RESUBMITS CLAIMS AND PROCESS ALL INSURANCE/PATIENT CORRESPONDENCE.
• PURCHASES DOCUMENTATION TO EXPEDITE PAYMENT.
• FOLLOW UP ON ASSIGNED ACCOUNTS.
• USES COLLECTION TECHNIQUES TO KEEP ACCOUNTS CURRENT INCLUDING MONITORING FOR DELINQUENT PAYMENTS.
• SETS-UP FINANCIAL ARRANGEMENTS WITH PATIENTS AS NECESSARY.
• AS NECESSARY, ASSISTS PATIENTS WITH RESEARCHING AND OBTAINING COMMUNITY RESOURCES INCLUDING HOUSING, TRANSPORTATION, DRUGS AND PHARMACEUTICAL SUPPLIES, AND FINANCIAL RESOURCES.

Qualifications

• Level 1: High School Diploma or equivalent required. This position is entry level and requires 0-3 years of medical business office experience.
• Level 2: In addition to Level 1 requirements, minimum 3 to 5 years medical business office experience.
• Level Sr: In addition to Level 1 and 2 requirements, minimum five years medical business office experience.