Patient Access Service Representative

Description

Mission: Our mission is to provide exceptional, efficient, and cost effective orthopaedic surgical services to every patient and family we have the privilege to serve.

Main function: Responsible for performing a variety of clerical duties in a professional manner

Duties and responsibilities:

a) Schedule surgical/non-surgical procedures and ensuring accuracy of data entered into scheduling system in a timely manner.

b) Support patient scheduling systems in conjunction with clinical and medical staff and patient information.

c) Communicate schedule updates, i.e., cancellations, changes, and delays to appropriate staff/patients/family members/visitors.

d) Responsible for cancelling and rescheduling patients when necessary to ensure appropriate medical treatment and/or testing.

e) Accurately completes or assures completion of registration process and facilitates revenue enhancement through insurance verification, pre-authorization, verification of medical necessity and follow up of denials.

f) Obtains treatment authorization(s).

g) May collect patient co-pays, co-insurance, self-pay balance and/or deductible and follow up with insurance companies for payment, enter patient payments, and maintain monthly/quarterly record statistics.

h) Coordinate multiple phone lines and or PM communications, take messages, screen calls, receive information and transfer calls to appropriate extension.

i) Relay messages to appropriate staff in order to facilitate communication and assure quality of care.

j) Support co-workers in operational functions of the office including: front desk coverage, answering phones, and running errands.

l) May coordinate translation arrangements for day and time of patient services.

m) Responsible for the patient registration process (check in and check out) for the center.

n) Assist patients with forms obtaining all necessary insurance information and signatures as needed.

o) Obtain pre-certification and/consent for services and billing.

p) Monitor and follow-up on additional pre-authorizations for on-going patient services needed.

q) May collect co-pay/co-insurance/deductible based on insurance plan(s) and self-pay amount(s).

r) Specifically, answering phones, assisting patients with questions and problems, and accepting/relaying messages.

s) Ensures compliance with federal, state, and local laws and regulations pertaining to patient privacy and confidentiality, i.e., HIPPA laws.

t) Performs other duties as assigned.

Requirements

Required

1. High school diploma or GED certificate
2. Minimum of one year if experience in a customer service position, preferably in a medical practice setting
3. Medical terminology
4. Computer fluency/literacy
5. Communication skills (verbal and written)
6. Maintain patient confidentiality
7. Organization and prioritization skills

Preferred

1. Patient Access Service Representative experience
2. ASC experience 

Physical/mental requirements:

1. Ability to sit, stand, and walk for long periods
2. Visual and auditory acuity for frequent use of computer and telephone and occasional use of other office equipment 

Working conditions (environmental):

1. Well-lit and ventilated, with non-hazardous and hazardous equipment
2. Category III: exposure to bloodborne pathogens and may encounter chemical hazards