Patient Services Representative - NBGW ENT (Full Time, Day)

NorthBay Health•Fairfield, CA

2d•$27 - $33

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, and after treatment. The role obtains and updates insurance, financial, and demographic information and explains options for meeting financial obligations, including copayments, deductibles, and coinsurance. It establishes payment plans, collects self-pay and residual balances, and helps resolve patients’ financial issues throughout their treatment. The representative provides guidance regarding medical bills and acts as a liaison among patients, insurance companies, and care teams, coordinating payments and answering questions so patients and physicians can focus on healthcare. The position also coordinates elective and non-elective surgery scheduling, supports continuity of care across departments, and assists other Patient Services Representatives as needed. 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.
Two or more years of experience working with referrals and consult processes in an ambulatory care setting.
Excellent customer service skills and comprehensive understanding of revenue-cycle workflows and processes.
Excellent analytical and project management skills; ability to work on multiple projects and manage deadlines.
Good organizational skills; ability to work independently and prioritize multiple projects and objectives in 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 reports by name, date, or descending dollar order.
Ability to determine appropriate questions, actions, and research needed to respond to patients, providers, or payers.
Knowledge of medical terminology, CPT, ICD-10-CM, Revenue Codes, Medicare guidelines and regulations, billing and follow-up practices, billing requirements for all payer types, and managed care terminology.
Knowledge of Cerner, Microsoft Outlook, Word, and Excel.
Adhere to established policies and procedures and attendance and punctuality standards.
Meet the role's physical demands, including prolonged standing and sitting, some walking, and extensive use of the telephone and computer keyboard; reasonable accommodations may be made.
Attendance is an essential function of the job.

Nice To Haves

High school graduate preferred.
Associate degree preferred.
Bachelor’s degree preferred.

Responsibilities

May provide cost estimates for outpatient and inpatient care.
Educate patients about payment options and financial assistance.
Negotiate and strategize patient payment arrangements.
Update patient accounts and balances.
Review and process patient and insurance company forms.
Communicate with patients, insurance companies, the Ambulatory Surgery Center Scheduler, and the OR Scheduler by phone.
Coordinate with surgeons and 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.
Communicate and collaborate with other departments to provide continuity of care across departments and disciplines.
Assist PSRs 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 or interdisciplinary committees.
Perform other duties as assigned.
Obtain and update insurance, financial, and demographic information; explain financial obligations and options; establish payment plans; collect self-pay and residual balances; and assist with patients’ financial issues before, during, and after treatment.

Benefits

Medical, dental, and vision insurance, subject to eligibility requirements.
Life, disability, and long-term care coverage, subject to eligibility requirements.
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.