Patient Services Representative-Ambulatory

Alameda Health System•Oakland, CA

About The Position

Under general supervision, the Patient Services Representative (PSR) provides specialized clerical support to clinic registration units and screens patients for possible eligibility for financial assistance programs. The PSR performs patient registration and less complex enrollment of eligible patients in programs such as the Childhood Health and Disability Program (CHDP), AHS’s Charity Program, Presumptive Eligibility (PE), and the Cancer Detection Program (CDP). PSRs also support the day-to-day functions of ambulatory clinics and team-based care, and may be required to work at alternate locations as necessary. The role provides patient-centered service, coordinates with patients and healthcare providers, and supports registration, scheduling, billing, financial screening, insurance verification, referrals, and authorization processing. The PSR explains services, resources, program eligibility, policies, and financial obligations to patients, while maintaining accurate records and communicating relevant financial information to care teams.

Requirements

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

Nice To Haves

Medical terminology knowledge.
Bilingual ability.

Responsibilities

Provide respectful, patient-centered care responsive to individual preferences, needs, and values, and promote excellent service for internal and external customers.
Collaborate with patients and healthcare providers to deliver coordinated, high-quality care.
Register and preregister patients for ambulatory care; interview patients for billing and financial screening, establish sources of payment, prepare registration packets, and schedule appointments in person or by phone.
Explain financial obligations to patients or guarantors; collect and process payments, copayments, and prepayments; verify insurance eligibility and coverage.
Explain applicable laws, regulations, eligibility requirements, rights, and obligations for Federal, State, and County programs; assist with applications and forms and review them for completeness and accuracy.
Enter registration and billing information into computer applications and retrieve data to prepare reports related to patient census, insurance, and financial status.
Distribute, complete, and collect forms and documents; explain available services and resources; determine 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 communicate with providers and staff about conditions or diagnoses that may qualify patients for assistance with healthcare costs.
Respond to inquiries about AHS healthcare services, explain AHS and Ambulatory Care Services policies and procedures, and direct patients to appropriate service areas.
Process referrals and required authorization and prior authorization forms with health plans or provider groups as directed; prepare correspondence and notify patients and providers about authorization decisions or barriers to scheduled services.
Conduct outreach to support AHS organizational goals and initiatives.
Use standard office equipment and AHS applications, including electronic health record, financial billing and registration, and online resources, to communicate with and support patients and employees.
Provide backup and coverage support for Ambulatory Care Services as assigned.
Participate in performance improvement and quality control activities.
Perform other related duties as assigned.