Patient Services Representative-Ambulatory

Alameda Health System•San Leandro, CA

About The Position

Under general supervision, the Patient Services Representative (PSR) provides specialized clerical support to clinic registration units, screens patients for possible eligibility in financial programs, and performs patient registration and less complex enrollment into financial assistance programs. PSRs also support the day-to-day functions of ambulatory clinic practices and team-based care, and may work at alternate locations as necessary. Program enrollment responsibilities may include the Childhood Health and Disability Program (CHDP), AHS Charity, Presumptive Eligibility (PE), and the Cancer Detection Program (CDP). The role performs related duties as required. The PSR provides patient-centered service and coordinates with patients and healthcare providers to support high-quality care. Responsibilities include registration and appointment scheduling, financial screening and payment processing, insurance verification, explaining program eligibility and patient obligations, assisting with applications, maintaining records, processing referrals and authorizations, communicating with patients and staff, and supporting quality improvement activities.

Requirements

High school diploma or equivalent.
Demonstrated ability to use computer and telephone systems and navigate application systems.

Nice To Haves

Medical terminology knowledge (preferred, not required).
Bilingual ability (preferred, not required).

Responsibilities

Provide patient-centered care that respects and responds to individual patient preferences, needs, and values, and promote excellent customer service for internal and external customers.
Collaborate with patients and healthcare providers to deliver coordinated, high-quality care.
Register and pre-register patients for ambulatory care services; interview patients to obtain billing and financial-screening information; process documents to establish payment sources; and prepare registration packets and patient visits.
Schedule appointments in person or by phone while providing excellent customer service.
Advise patients and guarantors of financial obligations; collect and process payments, co-payments, and pre-payments; and verify insurance eligibility and coverage.
Interpret applicable federal, state, and county program rules and explain eligibility requirements, rights, and obligations to patients; assist with applications and forms and review them for accuracy and completeness.
Enter registration and billing information into computer applications according to guidelines; retrieve data and prepare reports related to patient census, insurance, and financial status.
Distribute, complete, and collect forms and documents; explain available services and resources; identify enrollment options and enroll eligible patients in financial assistance and health coverage programs as needed.
Maintain records of unit productivity, patient location, registration, and discharge.
Inform medical providers of patients’ financial status and maintain communication with providers and staff, including timely notification of conditions or diagnoses that may qualify patients for assistance with healthcare costs.
Respond to inquiries about AHS healthcare services, explain AHS and ambulatory care policies and procedures, and direct patients to appropriate medical service areas.
Process referrals and submit required authorization and prior authorization forms to health plans or medical/provider groups as directed by referring providers.
Generate required correspondence and review notifications to patients and providers concerning authorization determinations or barriers to scheduled services, such as self-pay, continuity of care, or cancellation.
Conduct outreach to support AHS organizational goals and initiatives.
Use and operate standard office equipment and AHS applications, including electronic health record, financial billing and registration systems, and online resources; communicate with patients and AHS employees by telephone, email, and other equipment.
Provide backup and coverage for Ambulatory Care Services as assigned.
Participate in performance improvement and quality control activities.
Demonstrate empathy for vulnerable populations and underserved patients.
Perform related duties as assigned.