Patient Service Representative - Operations

Springfield Clinic•Jacksonville, FL

8d•Onsite

About The Position

The Patient Service Representative - Operations discusses insurance coverage, usual and customary charges, Medicare and Medical Assistance availability, service reimbursement options, and the Clinic's billing and credit policies with patients. The representative works with insurance carriers to verify treatment benefits and addresses credit concerns about past-due accounts, making special arrangements when necessary to support timely payment. The role verifies referrals, coverage, benefits, and prior authorizations; reviews bad debt, collections, and denials; supports patients and staff with insurance and billing questions; and maintains accurate patient insurance and demographic information. The representative prepares account action worksheets for Patient Accounting, responds to patient requests, maintains statistics and relevant proficiency, and provides coverage at other Springfield Clinic locations as assigned. The position requires empathetic, professional patient service while following billing practices, privacy and safety procedures, and the Clinic's conduct and ethics standards.

Requirements

High school graduate or GED.
Ability to handle multiple tasks and prioritize in a fast-paced environment.
Strong verbal communication and listening skills.
Knowledge of computer systems, particularly registration and insurance screens.
Knowledge of Medicare, Medical Assistance, and other third-party payors.
Ability to work courteously and professionally with patients of all ages.
Ability to work tactfully with patients who have past-due accounts.
Ability to meet quality and performance guidelines.
Ability to maintain composure under stress.
Manual dexterity for using a telephone headset, calculator, and computer keyboard.

Nice To Haves

Two to three years of experience in medical billing and insurance.
Computer skills, including Microsoft Office.

Responsibilities

Verify and secure referrals.
Verify insurance coverage and benefits before treatment.
Secure prior approvals and pre-authorizations.
Review and take action on bad debt, collections, and denials.
Maintain proficiency in insurance and billing issues and serve as a resource to providers and staff.
Prepare account action worksheets and submit them to Patient Accounting for charge corrections.
Provide patients with a positive impression of the Clinic's billing department.
Enter or edit patient insurance coverage and demographic information when necessary.
Inform patients about the Clinic's billing and credit policies.
Answer patient questions about insurance coverage and other billing issues.
Respond to patients' verbal and written requests in a timely manner.
Maintain statistics.
Participate in Patient Accounting meetings and training sessions as appropriate.
Work empathetically with patients while following Patient Accounting billing practices and guidelines.
Provide coverage at other Springfield Clinic locations as assigned.
Comply with Springfield Clinic incident-reporting policies and procedures.
Complete OSHA and Springfield Clinic training and accomplishments as required by policy.
Provide excellent customer service and follow Springfield Clinic's Code of Conduct and Ethics Standards.
Perform other duties as assigned.