Patient Service Specialist IV
About The Position
1. Collects Critical Data Elements, registration information, completes related documents, and prioritizes workload. Monitors workload, identifies trends impacting revenue cycle processes and alerts departmental management. 2. Ensures accurate patient identification and addresses sensitive information with confidentiality. 3. Communicates insurance benefits and liabilities with customers. 4. Collects past, current and future payments due and advises customers of financial responsibility and resources. 5. Provides excellent customer service through all interactions and resolves complaints promptly. 6. Works well independently and as part of a team. 7. Accesses hospital systems, office technology, payer websites and other resources for assigned responsibilities. 8. Adheres to the Medical Center's Values and policies while meeting departmental productivity goals and standards. 9. Obtains authorizations, pre-certs, documentation when applicable, referrals, reviews and requests medical record information as necessary. 10. Communicates effectively with various internal and external healthcare team members. Serves as a resource to department management to ensure efficient operations and supervision of staff and is able to provide representation for management in departmental meetings. 11. Takes the initiative to assist staff with escalated customer service and work related issues. Demonstrates a working knowledge of all departments within the Corporate Revenue Cycle. 12. Assists with the development and training of new or less experienced staff. Serves as a highly experienced resource, trainer to staff and other departments as needed by department management. 13. Attends required training classes, seminars and meetings. Actively seeks continuous self-improvement, utilizes critical thinking, and recommends innovative solutions to enhance current work flow processes. 14. Performs additional tasks and special project responsibilities as requested by department management. Working knowledge of departmental and related Medical Center policies. Performs quality review functions as requested by department management.
Requirements
- Associate's degree with five years' direct experience required.
- Excellent oral, written, and interpersonal communication skills
- Problem-solving skills to identify research and assist in resolution of real time issues
- Exceeds CRC goals consistently and productivity standards based on department requirements
- Works independently with minimal assistance from leadership
- Data entry, keyboarding (WPM 45) and calculator skills
- Strong telephone etiquette
- Organization and time management skills
- Critical thinking and decision-making skills
- Ability to perform analysis
- Ability to multi-task
- Identification of system/process improvements
- Basic mathematical skills
- Basic understanding of ICD 9/10 and CPT codes
- Attention to detail
- Ability to receive constructive criticism and take action
- Computer skills to include Microsoft products
- Presents/maintains a professional image
Nice To Haves
- Bachelor's degree preferred.
- Experience in a healthcare setting (receptionist, registration, financial assistance, etc.) preferred.
- Working knowledge of applicable rules, regulations and guidelines governing insurance payers and reimbursement preferred.
- Medical terminology preferred.
- Bilingual (Spanish) strongly preferred.
Responsibilities
- Collects Critical Data Elements, registration information, completes related documents, and prioritizes workload.
- Monitors workload, identifies trends impacting revenue cycle processes and alerts departmental management.
- Ensures accurate patient identification and addresses sensitive information with confidentiality.
- Communicates insurance benefits and liabilities with customers.
- Collects past, current and future payments due and advises customers of financial responsibility and resources.
- Provides excellent customer service through all interactions and resolves complaints promptly.
- Works well independently and as part of a team.
- Accesses hospital systems, office technology, payer websites and other resources for assigned responsibilities.
- Adheres to the Medical Center's Values and policies while meeting departmental productivity goals and standards.
- Obtains authorizations, pre-certs, documentation when applicable, referrals, reviews and requests medical record information as necessary.
- Communicates effectively with various internal and external healthcare team members.
- Serves as a resource to department management to ensure efficient operations and supervision of staff and is able to provide representation for management in departmental meetings.
- Takes the initiative to assist staff with escalated customer service and work related issues.
- Demonstrates a working knowledge of all departments within the Corporate Revenue Cycle.
- Assists with the development and training of new or less experienced staff.
- Serves as a highly experienced resource, trainer to staff and other departments as needed by department management.
- Attends required training classes, seminars and meetings.
- Actively seeks continuous self-improvement, utilizes critical thinking, and recommends innovative solutions to enhance current work flow processes.
- Performs additional tasks and special project responsibilities as requested by department management.
- Working knowledge of departmental and related Medical Center policies.
- Performs quality review functions as requested by department management.
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
1-10 employees
