Patient Services Representative

6445 Patient Access Specialist I

Performs receptionist, registration, and clerical duties associated with direct and scheduled patient admissions. Interviews patients for all pertinent account information and verifies insurance coverage.

Reports to: Assistant Director of Patient Registration

FLSA: Non-exempt

Education: High school diploma or equivalent Required or 3 years of directly related experience may be substituted for the required education.

License: N/A

Certifications: N/A

Minimum Work Experience

Billing or collection experience preferred. Computer experience required.

Required Skills

Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment.

Knowledge of medical terminology strongly preferred.

Ability to operate standard office equipment, including but not limited to, computer, printer, copier, fax, calculator.

Time management and organizational skills.

Essential Functions

Ensures that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy, assigning medical record number if appropriate.

Distributes and explains forms, documents, and educational handouts to patients or family members, ensures all necessary signatures are obtained for treatment.

Meets with patient or patient's caregiver before or after admission to exchange necessary information and documentation. Provides explanation of process and addresses concerns and questions.

Communicates with admitting physician's office, nursing unit staff, and/or other appropriate personnel regarding admission to exchange necessary information and determine placement.

Verifies insurance benefits and obtains precertification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for follow up.

Researches the patients visit history to ensure compliance with third party payer requirements, completing appropriate documentation as applicable.

Collects co-pays and other funds from patients based upon established criteria.

Non-Essential Functions

Checks supplies and stocks supplies as needed.

Serves as back-up for other functional areas.