Patient Services Representative

Employee Type: Regular | Work Shift: Day - 8 hour shift (United States of America)

About the role

The purpose of this position is to register all patients needing services and handle all first call resolutions for the departments assigned. The role is responsible for obtaining accurate and complete demographic, financial, and medical information. The employee will transfer calls as appropriate, and/or make appointments as necessary. For procedures, the employee may pre-register the patient, verifying insurance, etc. In addition, the employee may assist with making referrals. The person performing this role anticipates and acts on the needs of our customers to enhance their patient experience. Responsible for pre-registering and scheduling moderately complex procedures and coordinating multiple resources for patient services. May also perform duties for prior authorization, referrals (incoming/outgoing), good faith estimates, and/or payment collections.

Responsibilities

• Engage patients throughout the registration process to create a welcoming and positive patient experience.
• Consistently display good customer service behaviors to all patients and visitors to promote positive patient experiences.
• Assist patients to their destination as needed and manage patient visitor flow according to hospital policy and safety guidelines.
• Obtain and accurately enter required information for registration into the electronic health system.
• Follow prescribed procedures for positive identification and medical record number assignment, so no duplication or wrong patient registrations occur.
• Review demographic and insurance information for completeness, and follow through with correcting any deficiencies, so collection efforts are not delayed due to insufficient or incorrect information.
• Ensure all appropriate signatures are obtained and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy Notice, AOB (Assignment of Benefits), Medicare Important Messages, etc.
• Provide information and/or handouts and answer questions on patient rights and responsibilities, HIPAA Privacy Notice, and any financial assistance documentation.
• Thoroughly and accurately document insurance verification information in the system, identifying deductibles, copayments, coinsurance, and policy limitations.
• Obtain referral, authorization, and pre-certification information if needed; document this information in the EHR, electronic health record.
• Answer all inbound and/or place outbound telephone calls as assigned and appropriately direct callers, ensuring all calls are handled efficiently and in a timely manner.
• Consistently exhibit the highest level of service to all callers and fellow staff.
• Contact patients by phone to remind them of upcoming appointments, relay instructions, and/or ask follow-up care questions as needed.
• Cancel and reschedule appointments as needed. May assist with identifying and initiating necessary referrals for specialist appointments, procedures, and tests.
• Organize, expedite, and follow up on any paperwork related to patient care.
• Schedule various types of appointments for providers and communicate any necessary instructions to the patient.
• Perform various administrative support duties for department/work location.
• Open, sort, and distribute all types of mail and correspondence as necessary and assigned.

Requirements

• High School Diploma or equivalent
• Two (2) years of related customer experience, preferably in healthcare
• Experience demonstrating proficiency in scheduling OR pre-registering patients. May consider prior call center experience.

Skills and Abilities

• Ability to interact successfully with the public.
• Ability to perform effectively despite sudden deadlines and changing priorities; maintaining personal composure in high-stress situations.
• Ability to demonstrate a high level of interpersonal skills required to interact with patients, patients’ families/visitors, and clinical staff.
• Ability to perform with a high degree of accuracy and with meticulous attention to detail.
• Strong ability to use initiative and judgment and to identify, analyze, and solve problems.

Physical Demand

Light Physical Demand