Patient Services Representative-Ambulatory

Alameda Health System•Newark, 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 for financial programs, performs patient registration, and assists with less complex enrollment in financial assistance and health coverage programs. The PSR is also part of the ambulatory care team and supports the day-to-day functions of clinic practices and team-based care. The role may require work at alternate locations as necessary. Program enrollment may include the Childhood Health and Disability Program (CHDP), AHS’s Charity Program, Presumptive Eligibility (PE), and the Cancer Detection Program (CDP). Performs related duties as required. The PSR provides patient-centered customer service; coordinates with patients and healthcare providers; registers and schedules patients; conducts financial screening; verifies insurance eligibility and coverage; collects payments; explains financial obligations and program eligibility; and assists patients with applications and forms. The role enters and retrieves registration, billing, census, insurance, and financial information; maintains unit records; explains available services and resources; and communicates with providers and staff about patient financial status and potentially qualifying health conditions. The PSR also responds to inquiries about AHS services and policies, processes referrals and authorization paperwork, communicates authorization outcomes or barriers to scheduled services, conducts outreach, operates standard office equipment and AHS applications, provides backup coverage, and participates in performance improvement and quality-control activities. The position requires empathy for vulnerable and underserved populations. The stated pay range is $38.56 per hour. Final compensation depends on factors including experience, education, skills, licenses and certifications, departmental equity, applicable collective bargaining agreements, and organizational needs. Eligible positions are offered a comprehensive benefits program.

Requirements

High school diploma or equivalent.
Demonstrated use of computer and telephone systems and general navigation through application systems.
Ability to empathize with vulnerable populations and underserved patients.

Nice To Haves

Medical terminology knowledge is preferred but not required.
Bilingual ability is preferred but not required.

Responsibilities

Provide patient-centered care and excellent customer service to internal and external customers.
Collaborate with patients and healthcare providers to support coordinated, high-quality care.
Register and preregister patients for ambulatory care, obtain information for billing and financial screening, establish sources of payment, prepare registration packets, and schedule appointments in person or by phone.
Advise patients or guarantors of financial obligations and collect and process payments, copayments, and prepayments.
Verify insurance program eligibility and coverage for ambulatory care services.
Interpret federal, state, and county program rules and explain eligibility requirements, rights, and obligations to patients.
Assist patients with applications and forms and review submissions for accuracy and completion.
Enter registration and billing information into computer applications; retrieve data and prepare reports related to patient census, insurance, and financial status.
Distribute, complete, and collect ambulatory care forms and documents; explain available services and resources.
Determine enrollment options and assist eligible patients with enrollment in financial assistance and health coverage programs.
Maintain records of unit productivity, patient location, registration, and discharge.
Inform medical providers of patient financial status and communicate with healthcare providers and staff about conditions or diagnoses that may qualify patients for assistance programs.
Respond to inquiries about AHS healthcare services, explain AHS and ambulatory care policies and procedures, and direct patients to appropriate service areas.
Process referrals and submit authorization and prior authorization forms to health plans or medical/provider groups as directed.
Generate correspondence and communicate authorization decisions or barriers to scheduled services, including self-pay, continuity-of-care, and cancellation issues.
Conduct outreach to support AHS organizational goals and initiatives.
Operate standard office equipment and AHS applications, including electronic health record, financial billing and registration, telephone, email, fax, and online resources.
Provide backup and coverage support for ambulatory care services as assigned.
Participate in performance improvement and quality-control activities.
Perform related duties as assigned.