Patient Services Representative III - GVHP GI (Temporary, Day)
About The Position
The Patient Services Representative III schedules surgeries and referrals in coordination with the care team and assists patients with financial clearance before, during, or after treatment. The role obtains and updates insurance, financial, and demographic information; explains options for meeting financial obligations such as co-pays, deductibles, and co-insurance; establishes payment plans; collects self-pay and residual balances; and helps address patients’ financial issues. The representative advises patients about medical bills and serves as a liaison between patients and insurance companies, coordinating payments and answering questions so patients and physicians can focus on healthcare. The role also supports billing and account activities, communicates with patients, insurers, schedulers, and other departments, and helps maintain continuity of care. It assists other Patient Services Representatives and undertakes special projects or committee work as assigned. The position’s hours are based on business need.
Requirements
- Minimum of two years of experience in a medical front office setting, including experience and knowledge of health insurance and benefit requirements.
- Two years of experience working with medical insurance plans.
- At least two additional years of experience working with referrals and consult processes in an ambulatory care setting.
- Excellent customer service skills and comprehensive knowledge of revenue-cycle workflows and processes.
- Excellent analytical and project management skills; ability to manage multiple projects and deadlines simultaneously.
- Good organizational skills; ability to work independently, prioritize multiple projects and objectives, and adapt to a rapidly changing environment.
- Ability to communicate clearly and effectively and relate cordially with coworkers, members, providers, and others.
- Ability to download and save reports in Excel and sort them by name, date, or descending dollar amount.
- Ability to determine appropriate questions, actions, or research needed to respond to patients’, providers’, or payers’ inquiries.
- Knowledge of medical terminology, CPT, ICD-10-CM, Revenue Codes, Medicare guidelines and regulations, billing and follow-up practices, payer billing requirements, and managed-care terminology.
- Knowledge of Cerner, Microsoft Outlook, Word, and Excel.
- Adherence to established policies and procedures and attendance and punctuality standards.
- Attendance is an essential function of the job.
- Ability to meet the role’s physical demands, with reasonable accommodations where applicable.
Nice To Haves
- High school graduation.
- Associate degree or bachelor’s degree.
Responsibilities
- Provide cost estimates for outpatient and inpatient care, as needed.
- Educate patients about payment options and financial assistance.
- Negotiate and develop patient payment arrangements.
- Update patient accounts and balances.
- Review and process patient and insurance company forms.
- Communicate with patients, insurance companies, Ambulatory Surgery Center schedulers, and OR schedulers by phone.
- Coordinate with surgeons’ care teams to schedule elective and non-elective surgeries in the Ambulatory Surgery Center and OR.
- Inform or update supervisory personnel about patient billing concerns.
- Answer patient billing questions and work with ambulatory accounting or insurance companies to correct billing errors.
- Collaborate with other departments to provide continuity of care across departments and disciplines.
- Assist other Patient Services Representatives with their workload and provide support as needed.
- Schedule referrals for orthopedic providers in clinic.
- Promote teamwork and maintain effective communication with internal and external customers.
- Work on assigned special projects and interdisciplinary committees.
- Perform other duties as assigned.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Disability coverage
- Long-term care coverage
- Paid time off, including vacation, sick leave, holidays, and bereavement
- 403(b) retirement plan with employer match
- Education reimbursement for eligible roles
- Professional development and training programs
- Employee Assistance Program
- Wellness programs
- Recognition programs
- Shift differentials
- Market-based compensation review and increases, subject to approval and organizational performance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
