Healthcare Operations Specialist

1 week ago

SaintBrieuc, Bretagne, United States APR Consulting Full time
Job Summary

We are seeking a highly skilled and detail-oriented Patient Services Representative to join our team at APR Consulting, Inc. As a Patient Services Representative, you will be responsible for providing exceptional patient care and administrative support in a fast-paced healthcare environment.

Key Responsibilities:
  • Patient Services:
    • Accurately schedule patients using the applicable scheduling system.
    • Complete computer-aided registration screens with parents/guardians via telephone or in person in a professional and courteous manner.
    • Collect accurate demographic and insurance information, updating systems as needed to ensure registration accuracy.
    • Reschedule appointments for patients who did not show or for ancillary services cancellations by providers/technologists.
    • Greet patients and parents courteously, arriving patients in the appropriate system based on department policy.
    • Obtain required consents for departmental procedures and ensure distribution of compliance-related materials.
    • Obtain copies of insurance cards and photo IDs to be stored in medical records, ensuring applicable insurance companies and CNMC HIM departments receive copies of relevant forms/documentation.
    • Respond to patient portal work lists, including appointment requests, fax queues, email requests, and messaging center work lists.
  • Information Verification:
    • Verify insurance eligibility using applicable eligibility systems, ensuring managed care carve-outs are adhered to.
    • Notify parents of the need for completed insurance referral forms or pre-authorizations prior to scheduled/unscheduled appointments.
    • Discuss co-payments, deposits, payment in full, or past due balance collections with parents prior to scheduled appointments in a professional and courteous manner.
    • Counsel parents or refer them to the Financial Information Center (FIC) for establishing payment schedules or methods of payment.
    • Verify insurance information is complete prior to procedures and collect and verify pre-authorization/referral information, aiming to obtain authorizations 5 days in advance of service.
    • Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.
  • Cash Collection:
    • Collect and record co-payments, deposits, and payments in full, providing payers with receipts.
    • Maintain departmental requirements regarding cash controls and collections.
  • Billing Preparation:
    • Reconcile schedules for upcoming clinic sessions, ensuring accounts are set up for billing and services requiring authorization are flagged.
    • Appropriately clear all walk-in appointments and ensure scheduled/unscheduled appointments are linked to the scheduling system.
  • Office Support:
    • Answer telephones and address caller needs appropriately, avoiding transferring calls for better service to families.
    • Distribute mail and work returned mail as needed.
    • Check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).
    • Maintain office files and office supplies at PAR levels.
    • Maintain a clean reception area and workspace.
    • Provide other support as needed.
  • Safety:
    • Speak up when team members appear to exhibit unsafe behavior or performance.
    • Continuously validate and verify information needed for decision-making or documentation.
    • Stop in the face of uncertainty and take time to resolve the situation.
    • Demonstrate accurate, clear, and timely verbal and written communication.
    • Actively promote safety for patients, families, visitors, and coworkers.
    • Attend carefully to important details, practicing Stop, Think, Act, and Review to self-check behavior and performance.

We are an equal opportunity employer and welcome applications from qualified candidates. If you are a motivated and detail-oriented individual with a passion for delivering exceptional patient care, we encourage you to apply for this exciting opportunity.

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