Patient Services Representative III

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 resolution for the assigned departments. 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 the patient experience.

Patient Services Representative III is responsible for scheduling complex and specialized procedures across multiple EMR modules/platforms (e.g., Surgery, Interventional Radiology, Recurring Services) and coordinating multiple resources for patient services. Will also perform duties for prior authorization, referrals (incoming/outgoing), good faith estimates, and/or payment collections. Fully competent at performing common tasks and responsibilities under general supervision, this is the full proficiency level expected of all employees.

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 to prevent duplication or wrong patient registrations.
• Review demographic and insurance information for completeness, and follow through with correcting any deficiencies to avoid delays in collection efforts.
• Ensure all appropriate signatures are obtained and forms completed, including Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy Notice, AOB (Assignment of Benefits), and Medicare Important Messages.
• Provide information and/or handouts and answer questions on patient rights and responsibilities, HIPAA Privacy Notice, and 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, appropriately direct callers, and ensure 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.

Qualifications

• High School Diploma or equivalent Required
• Associate's Degree with Medical Terminology course completion Preferred

Experience

• At least three (3) years of related customer-facing healthcare experience with at least one (1) year scheduling or pre-registering patients (on-the-job performance and demonstration of mastery of duties will be considered) Required

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 meticulous attention to detail.
• Strong ability to use initiative and judgment to identify, analyze, and solve problems.

Physical Demand

Light Physical Demand