JOB DESCRIPTION
JOB DESCRIPTION – Patient Services Representative L1
|The Patient Services Representative is the organization’s liaison between patients, patients' relatives, and the healthcare organization; |
|handles patients' questions and concerns in a confidential and professional manner Familiar with a variety of healthcare concepts, |
|practices, and procedures, including patient and insurance billing. Relies on extensive experience and judgment to plan and accomplish |
|goals. The core responsibilities of a Patient Services Representative are answering inbound calls and making outbound follow up calls while|
|using empathy and soft skills. Identify type of assistance needed such as updating information, making a payment, payment plan |
|arrangements and insurance related questions to ensure proper account resolution. This position requires the ability to work |
|independently, accomplish goals, excellent customer service and communication skills, creativity, patience and flexibility while |
|consistently meeting quality assurance and production standards. Patient Services Representatives rely on guidelines established by the |
|organization to perform job functions and work under general supervision in a moderately fast paced environment. Patient Services |
|Representatives usually report to the department lead or supervisor. |
|EDUCATION AND WORK EXPERIENCE: |
|High school diploma or equivalent. A minimum of one-year previous work experience as a customer service representative is required. Must |
|have full understanding of customer service and insurance follow-up concepts (i.e. Billing A+, Collections, Managed Care, Medicare, |
|Medicaid and Commercial Practices), and well-developed interpersonal skills. |
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|REQUIRED JOB KNOWLEDGE & SKILLS: |
|Ability to use proper language, grammar and style, in verbal and written communications |
|Timely arrival and reliable attendance record with willingness to help people every day |
|Basic knowledge of health care industry terms (e.g. primary care, provider, benefits, HIPAA, EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS,|
|DRGs and authorizations/referrals |
|Full understanding of HIPAA and PCI protocols |
|Good problem-solving skills to research information using available resources, reference FAQs, and other information resources. |
|Ability to focus completely on listening to caller, understand their message, comprehend the information and respond thoughtfully and |
|professionally. |
|Ability to source information rapidly in an electronic environment |
|Ability to navigate through multiple software and computer applications |
|Ability to type a minimum of 30 wpm |
|Detail oriented and well organized |
|Ability to perform under pressure in a calm manner while maintaining a professional attitude |
|Basic math skills to be able to calculate discounts, payment plan arrangements, validate contractual and out-of-pocket patient liability |
|Able to meet production standards with minimal errors |
|Ability to be flexible in fast past environment and adapt with change |
|Demonstrates ability to work as a team player and independently |
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|CORE RESPONSIBILITIES & JOB FUNCTIONS: |
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|Core responsibilities include but are not limited to the items listed below: |
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|Delivers a high-quality patient experience through inbound and outbound call resolution within established protocols with a focus on first |
|call resolution |
|Handle inquires via multiple communications channels in a patient friendly manner |
|Review, Interpret Patient Statements/EOB and Balance |
|Document concerns in a clear and concise manner regarding Patient/Client Follow-up Efforts |
|Identify Contractual and Administrative Adjustments |
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|This job description is not intended to be all inclusive; the employee will also perform other reasonably related business/job duties as |
|assigned |
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|Our Culture |
|We work hard to make Acclara a wonderful place to work. Our people are our greatest assets, and we encourage employees to grow and develop, |
|assuming greater responsibilities and leadership roles. |
|Put the Patient First: The philosophy behind our approach is simple: drive revenue by putting the patient first. While our philosophy is |
|simple, the key to our success is in the details. |
|Hard Work, Diligence to Every Detail, and Passionate Service |
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|WORK ENVIRONMENT: |
|Physical demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, |
|or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. Specific vision abilities required by the job |
|include close vision, distance vision, color vision peripheral vision, depth perception, and the ability to adjust focus. |
|Work environment: The noise level in the work environment is usually moderate. |
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Employee - Name Signature Date
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Manager - Name Signature Date
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