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, screens patients for potential eligibility for financial programs, performs patient registration, and assists with less complex enrollment in financial assistance programs. The role is also part of the ambulatory care team and supports the day-to-day functions of clinic practice and team-based care. PSRs may be required to work at alternate locations as necessary. Enrollment programs may include the Childhood Health and Disability Program (CHDP), Alameda Health System’s Charity Program, Presumptive Eligibility (PE), and the Cancer Detection Program (CDP). Related duties may be assigned. The PSR provides patient-centered customer service and coordinates with patients and healthcare providers to support high-quality care. Duties include registration and appointment scheduling, financial screening, eligibility verification, payment processing, patient education, application assistance, data entry and reporting, referral and authorization processing, outreach, and maintaining registration and productivity records. The role also uses standard office equipment and AHS applications, supports Ambulatory Care Services as assigned, and participates in performance improvement and quality control activities. The position requires a high school diploma or equivalent, demonstrated use of computer and telephone systems, and general navigation through application systems. Medical terminology and bilingual skills are preferred but not required. The stated pay is $38.56 per hour. Eligible positions receive a comprehensive benefits program; specific benefits are not listed.

Requirements

High school diploma or equivalent.
Demonstrated use of computer and telephone systems.
General navigation through application systems.

Nice To Haves

Medical terminology knowledge; preferred but not required.
Bilingual skills; preferred but not required.

Responsibilities

Provide patient-centered care that respects individual patient preferences, needs, and values, and promote excellent customer service for internal and external customers.
Collaborate with patients and healthcare providers to support coordinated, high-quality care.
Register and pre-register patients for ambulatory care services; interview patients to obtain billing and financial-screening information, establish sources of payment, prepare registration packets, and schedule appointments in person or by phone.
Advise patients or guarantors about financial obligations and collect and process payments, co-payments, and pre-payments.
Verify insurance program eligibility and coverage for ambulatory care services.
Explain applicable laws, regulations, eligibility requirements, rights, and obligations for federal, state, and county programs; assist patients with applications and forms and review them 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 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 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 with patients and providers regarding authorization determinations or barriers to scheduled services, including self-pay, continuity of care, and cancellation of schedules.
Conduct outreach to support AHS organizational goals and initiatives.
Use standard office equipment and AHS applications, including the Electronic Health Record, Financial Billing and Registration, and online resources, to communicate with and support patients and AHS employees.
Provide backup and coverage support for Ambulatory Care Services as assigned.
Participate in performance improvement and quality control activities.
Demonstrate empathy toward vulnerable populations and underserved patients.
Perform related duties as assigned.