Description

This is a fully remote position. Bilingual (English/Spanish) candidate preferred.

Essential Functions of the Patient Services Representative:

This position will be responsible for facilitating incoming calls from patients in order to quickly address questions and resolve claim concerns.

• Facilitates incoming calls from patients in order to quickly address questions and resolve claim concerns. This may also include updating demographic information, researching account transaction history, identifying potential coding problems and following up with insurance companies.
• Documents all communication appropriately for every account level interaction.
• Collects and processes payments from patients. Offer discounts to encourage immediate resolution of claim balance, per policy. Negotiate and set patient payment plans as necessary based on company guidelines.
• Accurately research and verify insurance eligibility when a guarantor/patient requests that the balance due be billed to an additional insurance payer. Suspends patient workflow when appropriate, while balance discrepancies, disputes, and insurance problems are addressed.
• Reviews patient registration, insurance, and third party payments in the medical billing system; including a thorough knowledge and understanding of medical EOB’s, patient deductibles and co-pays, and insurance or third party correspondence, contractual payments, and adjustments.
• Must maintain 95% quality rate based on audit criteria. Achieves goals set forth by the supervisor regarding error-free work, transactions, processes, and compliance requirements. Average Handle Time of 5.5 minutes or less.
• Ability to handle multiple priorities at one time, ability to work independently with minimum supervision, and ability to manage and prioritize work queues and paperwork accurately under pressure of Client deadlines.
• Participates in staff meetings, trainings, and conference calls as requested and/or required.
• Maintains strict patient and provider confidentiality in compliance with all federal, state, and hospital laws and guidelines for release of information.
• Reliable, consistent attendance is a requirement and essential function of this position.
• Perform other duties as may be assigned.

Requirements

Competencies for the Patient Services Representative:

• High School Diploma or GED, College degree preferred.
• At least two years of experience in the same/related field.
• Strong verbal, written, and negotiation skills are required to deal with patients' issues.
• Extensive knowledge on the use of email, search engine, Internet; ability to effectively use payer websites and payment gateway; knowledge and use of Microsoft Products: Outlook, Word, Excel. Preferred experience with various billing systems.
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• The employee is required to sit in front of a computer throughout the work day. The employee will infrequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and working with two monitors.

06162022