Patient Representative

The Practice Representative is responsible for collecting and inputting patient demographic information to create and maintain medical records, facilitating the billing process with accurate demographic and payer details.

Key Responsibilities:

Insurance Verification & Eligibility:

• Place outbound calls and/or conduct online research to verify insurance coverage and eligibility before new patient appointments.

• Obtain necessary managed care referral guidelines.

Patient Communication & Referrals:

• Inform patients of pending insurance referral/authorization requirements based on appointment type.

• Ensure required patient referral/authorizations are received before the appointment.

Billing & Payment Collection:

• Confirm appropriate insurance benefit plans based on the patient’s appointment needs.

• Collect patient deductibles, co-pays, and co-insurance as applicable.

• Provide cash rate estimates for patients before their visits.

Administrative Tasks:

• Process daily insurance and consultation paperwork, including data entry and updating notes.

• Utilize practice management systems to manage pending appointments.

• Accurately register patient demographics in the system, including insurance and authorization details.

• File documents in electronic medical records as required.

Other Duties:

• Perform additional administrative tasks as assigned.

• some travel is required when necessary
• Saturday clinic rotation is required
• late clinic day rotation is required

***Requirements

Qualifications & Skills:

• Strong communication skills for patient and insurance interactions.

• Proficiency in using practice management systems and electronic medical records (EMR).

• Attention to detail in data entry and document management.

• Basic knowledge of insurance policies, referrals, and authorizations.