Patient Service Representative I

Representative, Patient Service Rep I

A Brief Overview

This position serves as the primary access point for patients within the inpatient and outpatient medical clinics / practices and is the initial focal point of the patient experience. Responsible for the gathering, entry and verification of registration information. In addition, this position is responsible for the collection of co-pays, may provide entry of patient charges and facilitates the care process by effectively processing information in a timely and accurate manner. This position must retain a high level of professionalism at all points of time.

What you will do

• Greets patients upon arrival in practice.
• Completes and verifies registration information for each patient :
• Verifies patient identity per protocol.
• Verifies address utilizing open ended questions.
• Ensures benefit verification process for current service date has been completed.
• Scans insurance card(s) into system.
• Ensures patient has received HIPAA, Financial Policy, MSP, Pt Notification of Provider based clinic (if appropriate) have been signed, and scans as needed into system.
• Collect co-pay as well as any outstanding self-pay balance :
• Provide patient with receipt of transaction.
• Enter into system.
• Maintain cash-drawer, reconcile any end-of-day cash receipts per ambulatory protocol.
• Updates system as “checked in” for communication with clinical staff.
• Works assigned encounter edits on a frequent basis throughout the day. Depending upon size of department assigned work could be also be Encounter Prep, Eligibility Checks, Appointments to schedule, Appointments to re-schedule, no-shows, encounters with no charge.
• Performs check-out duties for patients as they exit practice.
• Schedules patient for follow-up as requested by provider
• Provides assistance for referrals as directed
• Consistently monitors waiting room for potential customer service issues. Updates patients on a ten (10) minute frequency when providers are running behind in schedule.
• Understands and performs individual role in assuring compliance for regulatory, accreditation and system process.
• If assigned, answers phone and routes patient to appropriate clinical or administration area.
• If dedicated scheduling staff do not exist in the department, schedules both new patients and follow-up care based on patients calling into the practice. If scheduling new patients, responsible for obtaining necessary information for insurance verification.
• Maintains communication with Practice Manager on daily basis.
• Assists patients in obtaining necessary referrals for follow-up services. Also could be responsible for obtaining proper authorizations and pre-certifications for all outside procedures scheduled through the outpatient clinic or department.
• Maintains confidentiality of patient, department and hospital information. Adheres to established department and organization policies in processing and releasing patient information (i.e. HIPPA, Confidentiality and Compliance Policies).
• Back-up and provides coverage for relief and absences as required. Demonstrates flexibility of work schedule / duty assignments.
• Performs other duties and responsibilities as required.

Qualifications

Physical Demands

Regional One Health is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

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