Patient Service Center Representative

GENERAL SUMMARY:

Responsible for a broad spectrum of duties beginning with the initial receipt of core data elements and completion of the pre-registration process including personal demographics, insurance coverages and patient contacts. Provides patient education regarding discussion of non-contract/out of network insurance and upfront payment options.

PRINCIPAL JOB FUNCTIONS:

1. Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. Adheres to federal regulations regarding Advance Directives, COBRA, Medicare, Corporate Compliance, Joint Commission, OSHA and HIPAA; reports safety and customer concerns.

3. Maintains productivity and quality standards as defined through the organizational and departmental goals and objectives.

4. Confirms/enters complete and accurate demographic and insurance information in the electronic medical record (EMR) and provides arrival and pre-procedure instructions by telephone during pre-registration process.

5. Receives incoming calls for scheduling of outpatient Medical Center services for designated departments and completion of pre-registration process

6. Performs outbound calls to complete pre-registration process for all pre-scheduled admissions and appointments.

7. Serves as a liaison to hospital departments and physicians’ offices for all missing outpatient orders and Appropriate Use Criteria (AUC) for radiology procedures.

8. Reviews and evaluates outpatient orders received from the physician and/or physician staff and enters into EMR.

9. Provides patient estimates and discusses payment options pre-service.

10. Responsible to meet production targets for daily phone calls and other production metrics as assigned.

11. Answers phone queue, returns messages and directs calls as appropriate.

12. Performs complete phone registration and verbal consents as needed.

13. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

14. Participates in meetings, committees and department projects as assigned.

15. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk “*”. Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of training and development principles and practices.

2. Knowledge of patient accounting operations, registration and standard intake techniques.

3. Knowledge of credit payment practices and procedures.

4. Knowledge of medical terminology.

5. Knowledge of ICD 10/CPT coding preferred.

6. Knowledge of federal regulations including COBRA, Advance Directives, Medicare, Medicaid, Joint Commission, OSHA and HIPAA as they relate to hospital intake and payment for services.

7. Knowledge of computer hardware equipment and software applications relevant to work functions.

8. Knowledge of customer service philosophies and practices.

9. Skill in the operation of a standard keyboard including 10-key pad.

10. Ability to prioritize work demands and work with minimal supervision.

11. Ability to communicate effectively both verbally and in writing.

12. Ability to maintain confidentiality relevant to sensitive information.

13. Ability to establish and maintain effective working relationships with all levels of personnel, medical staff, volunteer and ancillary departments including diverse patient populations.

14. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Associates degree preferred. One (1) year of relevant work experience (i.e. hospital registration, billing or insurance) preferred. Must be 19 years of age to witness legal consents.