The Patient Services Representative supports the complete and timely collection of outstanding self-pay balances for assigned groups by reviewing outstanding patient balances and following up as appropriate. The individual will serve as a liaison between operations and the revenue cycle department.
Essential Duties and Responsibilities:
- Analyzes and resolve patient balances, keeping self-pay A/R to no more than 10% over 60 days.
- Answers billing questions and inquiries from patients and internal staff.
- Updates patient files with address changes, contact information changes, etc., as needed.
- Reviews patient’s insurance and eligibility to ensure accuracy.
- Efficiently navigates assigned insurance companies' proprietary websites to review patient eligibility, research payments, etc.
- Keeps supervisor apprised of matters regarding self-pay accounts receivable.
- Responds to requests from patients in a timely fashion.
- Obtains/verifies all demographic, financial, and insurance coverage is up to date and complete.
- Provides patients with detailed self-pay responsibility.
- Explains charges, fees, and previous balances.
- Collects outstanding balances.
- Sets up payment plans with the patient, if necessary.
- Informs revenue cycle department of discrepancies that require follow up.
- Creates, maintains and updates reports, as directed.
- Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
- Checks work e-mail on a regular basis throughout the workday.
- Participates in and complete all required trainings and in-services.
- Performs other duties as assigned.
Minimum Qualifications:
- High School Diploma, or equivalent WITH a minimum of three (3) years related experience; OR an equivalent combination of education and/or experience.
- Must have knowledge of Internet and Microsoft Office software (MS Word, MS Excel, MS PowerPoint, MS Outlook).
- Must have excellent written and oral communication skills, including exceptional customer service.
- Must be able to establish and maintain effective working relationships with doctors, clinical staff, other co-workers and the public.
- Must be able to work individually as well as within a team.
- Must be able to follow both verbal and written instructions.
- Must be able to work a flexible schedule.
- Must be able to respond with patience and understanding during stressful conditions related to patient health and emergent situations.
- Must be able to multi-task and prioritize.
- Must demonstrate extreme attention to detail.
- Must possess strong organization skills.
- Must be able to problem solve and use reasoning.
- Must be able to meet predefined quality standards.
- Must maintain and project a professional attitude and appearance at all time.
- Must have a solid foundation of insurance knowledge and guidelines for third party payers.
- Must have a working knowledge of the healthcare field and medical specialty, as well as medical terminology.
- All staff are expected to have a strong desire to provide excellent customer service; to comply with the rules and regulations of those organizations to which we are accountable; to have high ethical and professional standards of conduct; and to have an attitude of wanting to continuously improve their own professional performance.
Preferred Qualifications:
- Two (2) years’ experience working with an Electronic Medical Record (EMR).
Driving/Travel:
The employee must have reliable transportation. Travel for this position may be required up to 25%. While the primary workplace may be closest to the employee’s home, work assignments could be in any of the Company’s locations.