Job Summary: At the direction and control of the Director of Revenue Cycle, the Patient Services Representative is responsible for coordinating admissions and/or registrations of patients, verify information received upon admission, pre-certification IP/OP admits, extensive knowledge of Commercial Insurance contracts, handles billing and collections of all commercial accounts.
Reports to: Director of Revenue Cycle
Education: High school diploma, one or two years of college preferred.
Experience: One-year prior experience preferred in a hospital, similar medical facility or physician office.
Principal Duties and Responsibilities:
- Interviews patient or his/her representative to obtain information necessary for treatment
- Inputs patient data into computer
- Explains hospital policies regarding deposits and prepayments
- Verifies insurance
- Assists patients in understanding his/her insurance benefits
- Files all commercial claims, follows up by phone or internet access
- Analyzes commercial remittances for payments/errors, reports denials from insurance
- Interviews patients to make arrangements for payments on delinquent accounts
- Analyzes and monitors the UB92 manual and commercial manuals for updates
- Reviews delinquent accounts, mails collection letters, telephones patients when appropriate
- Responsible for handling financial assistance forms
- Work up and request patient refunds on a weekly basis
- Works closely with physician offices on patient demographic information
- Faxes documentation to third party payers as requested
- Communicate effectively and tactfully, orally and in writing
- Proficient in the use of computer and accurate 10 key adding machine by touch
- Ability to work independently
- Detail oriented
- Ability to work with frequent interruptions
- Respond to patients and patient families in a courteous manner both on the phone and in person
- Regularly works as scheduled and follows attendance policy.
- May be required to work evenings, nights, and/or weekends on a regular or as needed basis.