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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