PATIENT SERVICE REP

Description

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.

Physical

Requirements:              Physical requirements include, but may not be limited to:

• Reaching and grasping with arms and hands
• Proofreading and checking documents for accuracy
• Using a keyboard to enter or transform words or data
• Hearing in normal and soft tones
• Ability to read and understand written English words and sentences
• Ability to communicate orally and in writing in English words and sentences
• Ability to understand spoken English words and sentences
• Ability to communicate with others by telephone and e-mail

The demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Critical Demands:

• Understanding, supporting and promoting the organizational values inherent in the philosophy of Mena Regional Health System
• Performing job duties in a manner which demonstrates the values of Mena Regional Health System and its commitment to customer service
• Ability to use good judgment with good computer skills
• Requires a high degree of tact, discretion, accuracy and confidentiality in dealing within the hospital as well as community
• Safety Sensitive Position
• Working with confidential information
• Complying with Human Resources policies and procedures
• Practicing regular and punctual attendance

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.

Qualifications

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.