Patient Service Representative
Position Title: Patient Service Representative
ADA: Full time position. Job duties may require holding/lifting patient to or onto exam table. Ability to sit and/or stand periodically during the workday. Computer data entry a portion of job duty.
OSHA: Must adhere to universal precautions, to include blood borne pathogen protection, at all times.
Role and Responsibilities:
- Employee has a working knowledge of and is able to explain all aspects of the Medical Records Policies and Procedures. (i.e., release of records, subpoenas, etc.)
- Greets patients as they arrive, has patient sign in, verifies demographic information and ensures ready “for staff” status changes. Maintains a warm and friendly environment and exhibits good customer service.
- Properly works “Eligibility Issues Bucket”, for any insurance discrepancies the day before scheduled. Monitors next day appointment status by utilizing the automated eligibility and phone list report.
- Responsible party and patient demographics including address verification, are completely entered into the system in accordance with the policy and procedure manual to include name, date of birth, income, family size, alerts, PCP and contact preference
- Properly identify and verify third‐party coverage, sliding fee scale eligibility and complete appropriate forms (i.e., insurance verification form, income information form, Availity, Medicare questionnaire[MSP], Medicaid verifications, etc.). Obtain proof of income annually with tax return or three consecutive pay stubs. Ensure proper pay codes are added to account including selecting proper carriers and ID numbers as required for accurate billing.
- Understand definition of and determines migrant seasonal farm worker status, homeless status, and properly enters into EHR Systems
- Employee accurately explains patient responsibility for all payor codes. (i.e., insurance, sliding fee scale, Medicaid, Medicare, and special programs).
- A properly executed consent for treatment and Health Care Proxy and Contact Information Form are obtained according to policy.
- Maintains cash drawer ensuring accuracy and security at all times. Cash drawer consistently balances preventing shortages/overages. Ensure cash drawer is balanced upon leaving for and returning from lunch
- Explains charge totals for the day and patients portion to the patients. Collects appropriate co‐pays, co‐insurance and sliding fee scale portions during registration and/or exiting patient. Review outstanding balances in patient accounts
- Review the current day’s charges with patient
- Review account past‐due balance. (i.e., ROA, CIB, Bad debt.)
- Process receipt for patient and keeps a signed copy of credit card payments
- Timely entering of the completed encounter ensuring proper payor codes, correct site location, and diagnosis are assigned. (Encounters must be entered by noon on the 2nd business day after the date of service.)
- Reviews workflow dashboard, claim in hold, patient account holds, and ensures all claims are created and resolved. Completes deposit slip, balancing cash & checks to DCRJ
- Process charge entry user audit report and balances charges to encounters and payments Daily Cash Receipt Journal (DCRJ) and compares data entry on report
- Balance and complete DCRJ accurately and completely
- Ensure all receipts are accounted for and used in sequential order.
Qualifications and Education Requirements:
- High School Graduate or Equivalent
- One (1) year of Data Entry/Medical Office experience ( Preferred )
- Strong Customer Relations Skills
This job description is not intended to be all-inclusive, and the employee will also perform other reasonable related business duties as assigned by supervisor.
- This organization reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract of employment.