PATIENT SERVICE REPRESENTATIVE

4 weeks ago

Plainfield CT USA, United States Day Kimball Hospital Full time
Patient Service Representative: Plainfield Location

1st shift

40 Hours

Day Kimball Medical Group Orthopedics

JOB SUMMARY Patient Service Representative:

The Patient Service Representative is a multi-tasking position that consists of all front-end functions including customer service, telephone management, scheduling, registration, copay collections, time of service account management, coding review, charge entry, and appropriate cash and end-of day closure procedures. The PSR will ensure that all provider schedules are appropriately populated, telephones are responded to according to established protocols, and complete registration information is captured prior to, or during each patient visit. In this role, the PSR will perform appropriate and timely charge entry, if not performed electronically through an EMR, for all patient visits including a review of encounters and recommendations for appropriate procedural coding, manage cash drawers according to established protocols, post cash to patients accounts, manage patient responsible account balances at the time of service, and correct assigned claims edits for expedient submission to carriers.

ESSENTIAL RESPONSIBILITIES:

Responsible for collaborative interaction with patients, physicians, other staff members and management, patient satisfaction and accurate processing of all front-end functions are integral to the success of this individual.

Plans and directs pre-verification of patient insurance, registration, billing and collections, and data processing to ensure accurate patient billing and efficient account collection.

Appropriately responds to patient inquiries via telephone following established protocols

Follows procedures for verification of patient demographics information including insurance verification prior to the patient visit for all pre-scheduled patients

Utilizing established protocols, appropriately schedules patients whenever possible, at the patients' convenience for physician visit

Registers all patients at each visit utilizing established policies for the capture of complete and up-to-date patient and insurance information. Receives and documents in the information system patient responsible payments including co-payments, past balance payments, and time of service patient-responsible charges

Check-out each patient via established policies, including charge entry for current visit if appropriate, scheduling of future appointments, facilitation of ancillary procedures as necessary, and provides for the patient a receipt for services rendered

Will consistently perform surgical and other hospital charge entry functions as assigned and collaborate with providers regarding appropriate coding procedures

Following clinic policy, appropriately reconciles cash and charge batches, balances cash drawer, prepares deposits, and reconciles charges to visits and the co-pay holding file with an accurate balance for each opened batch

As assigned, processes all referral requests by physicians and patients within a timely manner and according to clinic procedure

As assigned, processes and maintains medical records in accordance with records protocols

SKILLS AND ABILITIES Patient Service Representative:

* Good physical and mental health, able to assist with heavy lifting and capable of working under pressure.
* Ability to perform detailed assignments, work accurately, follow directions and assess priorities.
* Accurate and timely processing of all front-end functions (>97% )
* Excellent telephone skills as measured by random audits, and the absence or presence of patient complaints
* Attention to active collections of copayments and patient responsible balances
* Copayments collected versus expected at > 90%
* Past balance collected at time of service > 40%
* Adherence to established attendance and tardiness policies

QUALIFICATIONS:

Education:

* Completion of a high school diploma.
* College level courses preferred but not required.

Experience:

* Demonstrated competency with medical procedural coding (CPT/ICD9)
* At least 4 years of relevant front-desk and customer related experience, preferably within a healthcare environment
* Demonstrated competencies with cash controls, and typing skills at a minimum of 40 WPM.
* Prior experience and demonstrated competence with patient or customer information systems

JOB DUTIES/RESPONSIBILITIES:

* Demonstrate competency in utilizing resources to accommodate cultural needs of patients and customers such as dietary, religious and language needs.
* Must be able to maintain confidentiality in a professional manner.
* Participate in continuous quality improvement activities.
* Remain flexible in work schedule in order to provide the most effective and efficient support for the practice and Medical Group's mission.
* Demonstrate ability to communicate and interact with staff and physicians.
* Demonstrate knowledge of all practice and Medical Group policies relevant to the performance of their responsibilities.

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