Patient Services Representative

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Work Shift:

Join Team Tidelands and help people live better lives through better health!

The purpose of this position is to register all patients needing services and handles all first call resolution for the departments assigned. The role is responsible for obtaining accurate and complete demographic, financial, and medical information. The employee will transfer calls as appropriate, and/or make appointments as necessary. For procedures, the employee may pre-register the patient, verifying insurance, etc. In addition, the employee may assist with making referrals. The person performing this role anticipates and acts on the needs of our customers to enhance the patient experience.

Responsible for scheduling complex, and specialized procedures across multiple EMR modules/platforms (i.e., Surgery, Interventional Radiology, Recurring Services, etc.) and coordinating multiple resources for patient services. Will also perform duties for prior authorization, referrals (incoming/outgoing), good faith estimates, and/or payment collections. Fully competent at performing the common tasks and responsibilities under general supervision, this is the full level of proficiency that all employees are expected to achieve.

1 - Engages patients throughout the registration process to create a welcoming and positive patient experience. Consistently displays good customer service behaviors to all patients and visitor to promote positive patient experiences. Assists patients to their destination as needed and manage patient visitor flow according to hospital policy and safety guidelines.

2 - Obtains and accurately enters required information for registration into the electronic health system. Follows prescribed procedures for positive identification and medical record number assignment, so no duplication or wrong patient registrations occur. Reviews demographic and insurance information for completeness, and follows through with correcting any deficiencies, so collection efforts are not delayed due to insufficient or incorrect information.

3 - Ensures all appropriate signatures are obtained and forms completed including and not limited to the following: Medicare Secondary Payer Questionnaire, Advance Beneficiary Notice (ABN waiver), HIPAA Privacy Notice, AOB (Assignment of Benefits), Medicare Important Messages etc. Provides information and/or handouts and answers questions on patient rights and responsibilities, HIPAA Privacy Notice, and any financial assistance documentation.

4 - Thoroughly and accurately documents insurance verification information in the system, identifying deductibles, copayments, coinsurance, and policy limitations. Obtains referral, authorization and pre-certification information if needed; documents this information in the EHR, electronic health record.

5 - Answers all inbound and/or places outbound telephone calls as assigned and appropriately directs callers and ensures all calls are handled efficiently and in a timely manner. Consistently exhibits the highest level of service to all callers and fellow staff.

6 - Contacts patients by phone to remind them of upcoming appointments, relay instructions and/or to ask follow-up care questions as needed. Cancels and reschedules appointments as needed. May assist with identifying and initiating necessary referrals for specialist appointments, procedures and tests.

7 - Organizes, expedites and follows-up on any paperwork related to patient care.

8 - Schedules various types of appointments for providers and communicates any necessary instructions to the patient.

9 - Performs various administrative support duties for department/work location. Opens, sorts and distributes all types of mail and correspondence as is necessary and assigned.

EDUCATION: High School Diploma or equivalent, required.

EXPERIENCE:   At least three (3) years of related customer facing healthcare experience with at least one (1) year scheduling or preregistering patients.  On the job performance and demonstration of mastery of duties will be considered.

KNOWLEDGE/SKILLS/ABILITIES:

• Ability to interact successfully with the public. Ability to perform effectively despite sudden deadlines and changing priorities; maintaining personal composure in high stress situations.

• Ability to demonstrate a high level of interpersonal skills required to interact with patients, patients’ families/visitors and clinical staff.

• Ability to perform with a high degree of accuracy and with meticulous attention to detail. Demonstrate a strong ability to use initiative and judgment and to identify, analyze and solve problems.

EDUCATION:  Associates degree or Medical Terminology course completion.

Physical Requirements: Light Physical Agility Test (PAT) Rating

While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear. The employee must exert up to 15 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or up to 5 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.