In this role, the Patient Services Representative schedules medical procedures and services, creates reservations, performs preadmission, registration, discharge and transfer processes. They provide excellent customer service, assists patients with financial and billing inquiries and perform collection functions.

Essential Job Functions:

• Greets and registers patients upon arrival, collects patient demographics, referrals, guarantor, insurance and other billing information; interviews patients and other parties to obtain information
• Performs pre and post-billing functions, responds to patient inquiries in-person and via written correspondence, resolves patient charge disputes and processes patient refunds
• Verifies insurance coverage; obtains authorization from managed care companies to cover outpatient services; works with the Managed Care office to identify and interpret contracts governing patient care
• Identifies patients unable to meet complexity/payer mix requirements; provide assistance to identify a community resource for follow up care that matches their clinical needs
• Provides financial counseling to patients and their families; explains hospital policies, including payment and credit policies
• Identifies adjustments/discounts on claims, initiates resolution of accounts placed with collection agencies, receives and processes payments and works with patients to make payment arrangements balances due
• Initiates problem solving to resolve patient questions/complaints and refers escalated concerns to appropriate sources for resolution
• Prepares various correspondence and reports, clinic consultation notes, referral letters and other departmental correspondence; maintains correspondence files
• Answers incoming calls and assists with general clerical duties as needed within the department

Required Qualifications:

• High School Diploma
• Excellent interpersonal skills, including the ability to establish and maintain effective relationships with patients, physicians, management, staff and other customers
• Exceptional customer service skills including the ability to use independent thinking, sound judgment and creativity when resolving customer issues
• Ability to balance multiple priorities and effectively handle challenging situations
• Excellent verbal communication skills
• Basic office skills including 35 wpm typing and 4500 key stokes an hour
• Ability to accurately and efficiently enter alpha numeric data on screen
• Knowledge of basic medical terminology
• Ability to use personal computers and select software applications including Epic
• Successful completion of competencies related to the Cadence Scheduling system
• Successful completion of competencies related to the Point of Service Collection policy

Preferred Qualifications:

• Associate or Bachelor’s Degree preferred
• Prior experience in a practice setting preferred including in depth knowledge of appropriate insurance protocols
• Spanish speaking preferred

Position Details:

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days – 10:30AM-7:00PM
• Unit/Department: Pediatrics
• CBA Code: 743 Clerical

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