Patient Service Representative

About This Role

This role is crucial for establishing and maintaining accurate patient medical records, ensuring patient safety, and facilitating smooth billing processes within a healthcare setting. The Patient Service Representative is the first point of contact for patients, handling registration, insurance verification, and financial discussions, while upholding strict confidentiality.

Responsibilities

• Create the initial electronic health record, forming the foundation of the patient medical record
• Prevent the creation of duplicate medical records to avoid treatment safety issues and billing problems
• Follow and ensure compliance with organizational mandates for positive patient identification prior to care delivery
• Check in and register patients, obtaining and verifying complete demographic, guarantor, and insurance information
• Discuss and collect co-pays and other out-of-pocket patient responsibilities
• Maintain complete confidentiality regarding patient personal/financial information and medical records in accordance with HIPAA
• Understand insurance basics and recognize commercial and government plans
• Know which plans AAH contracts with and when a statement of financial responsibility is needed
• Understand and discuss financial information and obligations with patients
• Know how and when to refer patients to Financial Advocates
• Have knowledge of rules, forms, and questions to enforce compliance with government agencies and regulations (e.g., HIPAA, EMTALA, Consent for Treatment, Patient Rights and Responsibilities, IMM, MOON, Notice of Privacy Practices, MSPQ, ABN)
• Obtain patient or guarantor signatures as required
• Schedule patient appointments, including virtual and procedural, and coordinate cancellations, reschedules, wait list requests, and recall requests
• Provide accurate, detailed information regarding test preparations, patient arrival time, medication/food/beverage consumption guidelines, check-in procedures, and directions to facility
• Perform visit closure, including checking out patients, scheduling follow-up appointments, and providing after-visit summaries
• Educate and support patients with the patient portal/app
• Create a welcoming and professional environment for patients and visitors by demonstrating extraordinary customer service
• Greet patients and visitors and respond to routine requests for information
• Answer telephone, screen calls, and take messages
• Maintain excellent public relations with patients, families, and clinical staff
• Demonstrate a willingness and ability to work collaboratively with others for concise and timely flow of information
• Proactively communicate issues involving customer service and process improvement opportunities to management