Patient Service Representative-(Full-Time)

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. May be required to work evenings, nights, and/or weekends on a regular or as needed basis. Other duties as assigned.

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. 

Primary Job Duties: 

  • Interviews patient or his/her representative to obtain information necessary for treatment
  • Provide population specific care- i.e. Language Line, Speak Clearly, ADA accommodations.
  • 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 UB04 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
  • Performs other duties as assigned.
  • May be required to work evenings, nights, and/or weekends on a regular or as needed basis.
  • Regularly works as scheduled and follows attendance policy.