FLSA Status: Non-Exempt

Original Date: January 2020

Last Revised: January 2022

JOB SUMMARY: The Patient Services Representative I puts their heart into their work every day. Our representatives lead with empathy and are passionate about showing compassion, ensuring quality work, and providing patients with a stress-free experience while they are registered for healthcare services. Whether it’s making patients more comfortable while they wait, checking in on them with updates or going the extra mile to help someone navigate the hospital/clinic, our colleagues know that registering a patient is not a task-oriented career, it’s a people-oriented one

EDUCATION/EXPERIENCE: High school diploma or GED required. Patient access (scheduling, registration and financial clearance), insurance verification, billing or certified medical assistant experience preferred.

LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A

ESSENTIAL FUNCTIONS: 

1. Delights patients with an engaging and personable experience in all encounters. 
2. By providing a superior patient experience, receives high satisfaction survey scores from patients, at or above goal. 
3. Develops and maintains a solid understanding of the revenue cycle and how patient registration affects the billing process. 
4. Takes advantage of all training provided and ensures expertise in hospital/clinic systems including CarePricer, HIPAA confidentiality, healthcare insurance payer portals and protocols, insurance verification and data entry protocols, which hospital/clinic documents are required for medical and financial compliance, navigating the hospital/clinic and understanding and applying age specific competencies, among others. 
5. Completes the registration process while meeting quality and wait time goals.
   1. This includes obtaining all required information for hospital/clinic records and billing systems, obtaining patient and/or responsible party signatures on registration and providing required information to patients/responsible party concerning Advanced Directives if applicable, Privacy, Medicare and required other compliance or consent forms. 
   2. This may also include insurance coverage verification, obtaining authorization for services requiring pre-certification or referral, collecting payments, and/or preparing charts/paperwork for patient visits. 
6. Depending on the assigned client location, may screen patients for Medicaid, Affordable care Act or hospital sponsored financial program and provides appropriate documentation and referral. May provide bedside financial counseling and collection support by telephone for patient balances after discharge. 
7. Depending on the assigned client location, may place an identification wristband on the patient and always follows hospital/clinic patient safety procedures for patient identification and medical record management.
8. Performs clerical functions as needed, including answering phones, taking messages, chart processing, filing, faxing, etc. 
9. Depending on the assigned client location, may cross-train in patient services for other departments and/or work in other departments to cover for staffing gaps. 
10. Continually serves as nThrive’s front line ambassador for ensuring each patient is treated with respect and receives the highest quality care and service. 
11. Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA and other laws applicable to nThrive’s business practices.
    1. This includes becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident.
    2. HIPAA-compliant handling of patient information.
    3. Demonstrable awareness of confidentiality obligations.

SKILLS/QUALIFICATIONS:

• Experience showing initiative, including anticipating customer needs and going the extra mile to ensure an engaging and positive customer experience. 
• Demonstrated experience communicating effectively with a customer and simplifying complex information. 
• Experience working with customer support including issue resolution management. 
• Ability to multi-task and prioritize departmental functions to meet both timed deadlines and quality expectations with great attention to detail. 
• Demonstrated ability to meet performance objectives. 
• Ability to cross-train in other patient services departments. 
• Demonstrated success working both individually and in a team environment. 
• Demonstrated ability to navigate Internet Explorer and Microsoft Office. 
• Demonstrated ability to learn new technology, hospital/clinic protocols and commercial/government insurance plans, and to be fully trained and operating independently within the 90-day training period. 
• The work schedule may vary. The standard schedule for this position is posted, however, schedules can change over time and this role will also be asked to cover shifts as needed for schedule gaps.
• Experience working within the registration process in a hospital or physician office setting, including demonstrated success obtaining patient demographic and financial information, handling insurance verification and obtaining authorizations preferred. 
• Knowledge of commercial and government insurance plans, payer networks, government resources, and medical terminology preferred. 
• Basic understanding of patient access services and the overall effect on the revenue cycle. An understanding of commercial and government insurance plans, payer networks, government resources, and medical terminology preferred.

WORK ENVIRONMENT:

• The noise level in the work environment is usually minimal. 
• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards. 
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.

PHYSICAL REQUIREMENTS: