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Patient Services Representative
2 months ago
Full timeShift:
Rotating Shift
Description:
GENERAL SUMMARY
Under general supervision is responsible for the complete and accurate collection of patient demographic and financial information. Registers/checks-in patients, determines preliminary patient or insurance payment obligation, collects cash payments, initiates the billing and re-billings.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Interviews patients and gathers information to assure accurate and timely claims submission.
- Interprets information collected to determine and create comprehensive visit-specific billing records.
- Determines need for and obtains authorization for treatment/procedures and assignment of benefits as required.
- Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills.
- Provides assistance to other Health System or physician offices staff regarding registration information and procedures.
- Determines appropriate payment required at point of registration (deposits, co-pays, minimum charges and non-covered services. Collects payment at time of registration or check-out.
- Contacts patients to pre-register prior to clinical services.
- Verifies insurance coverage for selected services to facilitate cash collection.
- Obtains insurance benefit forms and completes as required; obtains signatures and approvals; verifies that information is complete and accurate.
- Utilizes automated systems to obtain and process information (Registration, Medipac, Blue Cross/HART, Medicare/DDE, Care Choices).
- Reviews Face Sheets, Patient Identification Forms and related system reports for accuracy; effect error corrections as appropriate.
- Responds to problems and questions from Medical Records, Clinical Departments or PFS Teams.
- Reviews and monitors mainframe error reports (Registration and Medipac 299) and effects corrections.
- Problem-solves charges, registration data (demographic, insurance) relating to patient inquiries.
- Demonstrates understanding of prevailing regulatory or 3rd party requirements (MS, pre-certification, consent forms, Advance Directive, etc.).
- Assists patients or physician office staff by referring to the appropriate sources of information.
- Identifies opportunities to improve the quality of registration, billing or verification procedures.
- Provides patient instructions, directions, and assistance with submission of patient-centered claim submission to insurance carriers.
- Explains accounts to patients; translates billing to patient understanding.
- Responds to patient questions concerning insurance coverage, benefit coverage for their insurance plans.
- Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their account.
- Knows where to obtain information to assist team members, patients, and internal or external customers.
- Demonstrates team-player abilities and seamless service to patients.
- Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner.
- Helps to identify problems, offer solutions, and participate in their resolution.
- Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to St. Joseph Mercy Hospital.
- Discusses patient and hospital information only among appropriate personnel in appropriately private places.
- Behaves in accordance with the Mission, Vision, and Values of
- Saint Joseph Mercy Health System.
- Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
Education:
Requires high school diploma or equivalent.
Experience:
One or two years related experience.
REQUIRED SKILLS AND ABILITIES
- Basic knowledge of accounting (debits and credits).
- Demonstrated computerized keyboard experience.
- Analytical and problem-solving skills.
- Effective interpersonal communication skills.
- Patience in dealing with ordinary, arduous or emotional patients.
- Use of telephones.
WORKING CONDITIONS - Normal office environment.
REPORTING RELATIONSHIPS - Supervision provided by Lab Manager.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.