Patient Service Representative I, Winston-Salem, Clemmons, Davie & Bermuda Run
- Greets patients arriving for their appointments. Monitors patient flow to ensure patients are cared for in the most efficient and courteous manner.
- Ensures all patient demographic and insurance information is complete and accurate
- Completes the registration process on walk-in patients, verifies and / or updates patient demographic and insurance information if changes or additions have occurred
- Verifies insurance benefits. Obtains, calculates and collects the patient's out of pocket financial liability. Requests and collects past due and present balances or estimates due
- Follows the Financial Clearance policy for non-urgent patient services if financial clearance has not been completed or authorization has not been obtained, when appropriate
- Identifies patients in need of financial assistance and refers patients to Financial Counselor
- Performs visit closure, including but not limited to checking out patients, scheduling follow-up appointment(s), collecting additional patient responsibility (when applicable) and providing patient with appropriate documents.
- Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization/referral and a list of current accepted insurance plans.
- Proactively communicates issues involving customer service and process improvement opportunities to management
- Meets productivity requirements to ensure excellent service is provided to customers
- Meets or exceeds performance expectations of 98% accuracy rate and established department productivity measurements.
- Maintains excellent public relations with patients, families, and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information
- Ability to identify and understand issues and problems.
- Examines data and draws logical conclusions based on information available
- Knowledge and ability to articulate explanations of Medicare, HIPAA, and EMTALA rules and regulations and comply with updates on insurance pre-certification requirements Mathematical aptitude, effective oral and written communication skills and critical thinking skills
- Understanding of basic human anatomy, medical terminology and procedures for application in the patient referral, pre-certification and authorization processes.
- Ability to speak effectively to customers or employees of the organization; presents a pleasant, professional demeanor and image during telephone conversation
- Ability to handle sensitive and confidential information according to internal policies
- Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals
- Experience with Microsoft Outlook, Word and Excel and ADT software
- Ability to write routine correspondence, calculate figures and amounts such as discounts and percentages
- Must be able to work with minimal supervision, to problem solve in a high profile and high stress area and interact positively with all internal and external customers while possessing the ability to determine priority of work
- Exposed to a normal office environment.
- Must be able to sit the majority of the workday.
- Occasionally lifts up to 10 lbs.
- Operates all equipment necessary to perform the job
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