Clinic Representative
About The Position
The Clinic Representative coordinates patient flow by answering phones, scheduling appointments, registering patients and insurance information, obtaining required signatures, and following established processes and standards. The role verifies insurance coverage, validates referrals and authorizations, collects patient liability, and provides financial guidance to support reimbursement. It also includes posting patient transactions at the point of service and releasing information in accordance with organizational and compliance policies and guidelines. The position works independently under regular supervision in a fast-paced, high-volume, multitask environment. It requires sound judgment to prioritize work and support timely, appropriate patient care, as well as the ability to retain changing payor information relevant to reimbursement. Primary external customers include patients and their families, physician office staff, and third-party payors.
Requirements
- High school diploma, GED, or equivalent working knowledge.
- One or more years of work experience involving knowledge of patient financial services, financial or collection services, or insurance-industry processes.
- Ability to manage multiple tasks simultaneously with minimal supervision and work independently.
- Strong interpersonal, oral, and written communication skills to interact effectively with a wide range of audiences.
- Strong knowledge of common office software, including word processing, spreadsheet, and database software.
Nice To Haves
- Work experience with the company’s systems and processes.
- Previous cash collections experience.
- Additional related education and/or experience.
Responsibilities
- Perform patient registration and check-in, including data entry, providing information and intake forms, obtaining signatures, and generating population health summaries.
- Verify insurance eligibility and benefits for services, document verification, and assist with obtaining or validating pre-certifications, referrals, and authorizations.
- Calculate and collect patient liability based on insurance benefits and expected reimbursement; explain financial policies and available alternative payment arrangements to patients and families.
- Enter payments and charges for services and complete daily payment and charge reconciliation accurately and promptly.
- Balance the cash drawer at the beginning and end of the day and prepare daily bank deposits with paperwork for centralized billing.
- Schedule office visits and procedures within the medical practice and external practices as needed, considering payor plan provisions to maximize reimbursement.
- Confirm next-day appointments as needed and ensure patients are properly prepared for visits.
- Address patient concerns by phone, email, and in person, and support patient flow through effective communication with customers, care teams, management, centralized services, and HIMS.
- Assist with requests for patient medical records in accordance with company policies and procedures and state and federal laws.
- Provide other patient-flow services as needed, including escorting patients, taking vitals and patient history, assisting with treatment, distributing mail and fax information, and ordering supplies.
- Prioritize work independently and use sound judgment to support the appropriateness and timeliness of patient care.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
