Patient Services Representative II
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we should only use those headings. If content doesn't fit, we could still put under appropriate heading like About the role for general description, but we have no About the role content. Could we put Work Environment under About the role? Might be okay but risk of adding filler. Better to omit if not matching.
Physical Requirements also not a standard heading; could be omitted.
We must preserve ALL substantive information; cannot drop content. So we need to include all info somewhere within allowed headings. We can embed Work Environment and Physical Requirements under About the role or Requirements? But we must not invent headings. We can put them under About the role as prose. That would be acceptable: About the role can contain general description, includes work environment and physical requirements.
Similarly, Reports To could be included in About the role or Requirements.
We need to avoid repeating job title.
We need to output HTML fragment only.
Let's structure:
About the role
Reports to Supervisor, Clinic Registration. High school diploma or equivalent and three years of experience working in a role within a customer service, fast‑paced environment with high volume of either calls or in‑person requests; or an equivalent combination of education and experience. Work environment: clean, indoor environment. Physical requirements: ... (we need to include the percentages and activities). We'll need to format that clearly. We can include a
- for list of activities with percentages? The physical requirements description: "Amount of time spent performing the following activities: 0%35%65%tototo35%65%100%N/AActivityXStandingXWalkingXSittingXBendingXReaching with armsXFinger and hand dexterityXTalkingXHearingXSeeingLifting, carrying, pushing and or pulling:X20 lbs. maximumX50 lbs. maximumX100 lbs. maximum"
This seems garbled. Probably the original had a table with percentages for each activity. The text is messy. We need to preserve ALL substantive information; we cannot invent or summarize away detail. We must output exactly as given? The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. So we need to include that physical requirements text verbatim, even if it's messy. We can put it in a
. Similarly, we need to include Essential Functions list. We need to include Skills & Qualifications list. We need to include Licensure etc? It's N/A, we should drop as per instruction: do not include sections with filler like N/A. So we omit that. We also need to include Reports To (we already included in About the role). Good. Now we need to decide headings: About the role, Responsibilities, Requirements, Qualifications, Skills. We have Education/Experience (could go under Requirements). We have Skills & Qualifications (could go under Skills). We have Essential Functions (Responsibilities). We have About the role (we already used for reports to, work environment, physical requirements). That seems okay. We must not create Pay/Schedule/Benefits sections because not present. Now we need to ensure we don't repeat content. Let's draft. About the role: include Reports To, Work Environment, Physical Requirements. Responsibilities: Essential Functions list. Requirements: Education/Experience. Qualifications: maybe we could put Licensure etc but it's N/A, so skip. Could we put nothing? Better to omit Qualifications heading if no content. But we have Skills & Qualifications; maybe we treat that as Skills heading. Qualifications could be omitted. Skills: Skills & Qualifications list. Now we need to format lists. Essential Functions list items: - Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems. - Pre-registers all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures. - Verify insurance coverage and obtains authorization for all services requiring pre-certification. - Process internal and out-going referrals, as needed, per department procedures - Perform clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning. - Collect and process upfront deposits or set-up payment arrangements, as required. - Screen patient for Medicaid, Affordable care Act or hospital sponsored financial program and provides 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 related duties - Complete assigned registration functions within multi-specialty clinic and/or emergency department, which may include claim edit work queues, pre-certifications and authorizations. - The Patient Services Representative III is expected to sequence multiple physician visits and complete registration activities within multiple registration platforms - Assists team with escalated issues, trains other team members as needed and is a subject matter expert. - Participate in departmental performance improvement initiatives - Other duties as assigned or requested by Supervisor or Manager, such as acting as back up in other departments - Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served. Note: Some items have weird capitalization; we keep as is. Skills & Qualifications list: - EPIC Cadence experience preferred. - Expert knowledge of patient access services and the overall effect on the revenue cycle. - A thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology. - Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served. - Demonstrated proficiency in communicating effectively with a customer and simplifying complex information. - Demonstrated ability of critical thinking skills and adhering to compliance protocols. - Demonstrated ability to handle escalated issues, train/mentor other team members and viewed as a subject matter expert. - Ability to navigate Internet Explorer and Microsoft Office Suite of applications. - Experience working in a role that requires 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. Now Physical Requirements text: "Amount of time spent performing the following activities: 0%35%65%tototo35%65%100%N/AActivityXStandingXWalkingXSittingXBendingXReaching with armsXFinger and hand dexterityXTalkingXHearingXSeeingLifting, carrying, pushing and or pulling:X20 lbs. maximumX50 lbs. maximumX100 lbs. maximum" We need to include that exactly. Now About the role paragraph: include Reports To, Work Environment, Physical Requirements. We can write: Reports To: Supervisor, Clinic Registration. Work Environment: Clean, indoor environment. Physical Requirements: [the text]. Now we need to ensure we don't repeat any info elsewhere. Now produce HTML:
About the role
Reports To: Supervisor, Clinic Registration. Work Environment: Clean, indoor environment. Physical Requirements: Amount of time spent performing the following activities: 0%35%65%tototo35%65%100%N/AActivityXStandingXWalkingXSittingXBendingXReaching with armsXFinger and hand dexterityXTalkingXHearingXSeeingLifting, carrying, pushing and or pulling:X20 lbs. maximumX50 lbs. maximumX100 lbs. maximum
Responsibilities
- Interview patients in-person and/or by phone to obtain all required information for hospital records and billing systems.
- Pre-registers all scheduled patients for admission, partial hospitalization, and outpatient services according to department policies and procedures.
- Verify insurance coverage and obtains authorization for all services requiring pre-certification.
- Process internal and out-going referrals, as needed, per department procedures
- Perform clerical functions as needed, including answering phones, taking messages, chart processing, faxing and scanning.
- Collect and process upfront deposits or set-up payment arrangements, as required.
- Screen patient for Medicaid, Affordable care Act or hospital sponsored financial program and provides 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 related duties
- Complete assigned registration functions within multi-specialty clinic and/or emergency department, which may include claim edit work queues, pre-certifications and authorizations.
- The Patient Services Representative III is expected to sequence multiple physician visits and complete registration activities within multiple registration platforms
- Assists team with escalated issues, trains other team members as needed and is a subject matter expert.
- Participate in departmental performance improvement initiatives
- Other duties as assigned or requested by Supervisor or Manager, such as acting as back up in other departments
- Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
Requirements
High school diploma or equivalent and three years of experience working in a role within a customer service, fast paced environment with high volume of either calls or in-person requests; or an equivalent combination of education and experience.
Skills
- EPIC Cadence experience preferred.
- Expert knowledge of patient access services and the overall effect on the revenue cycle.
- A thorough understanding of commercial and government insurance plans, payer networks, government resources and medical terminology.
- Understand and maintain operations knowledge of Medicare and other state and federal government payor compliance requirements for the population served.
- Demonstrated proficiency in communicating effectively with a customer and simplifying complex information.
- Demonstrated ability of critical thinking skills and adhering to compliance protocols.
- Demonstrated ability to handle escalated issues, train/mentor other team members and viewed as a subject matter expert.
- Ability to navigate Internet Explorer and Microsoft Office Suite of applications.
- Experience working in a role that requires 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.