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Patient Service Rep - SJMHS Chelsea

Position Purpose:
Under general supervision is responsible for the complete and accurate collection of patient demographic and financial information. Registers/checks-in patients, determines preliminary patient or insurance payment obligation, collects cash payments, initiates the billing and re-billings
ESSENTIAL DUTIES AND RESPONSIBILITIES
Interviews patients and gathers information to assure accurate and timely claims submission.
Interprets information collected to determine and create comprehensive visit-specific billing records. Determines need for and obtains authorization for treatment/procedures and assignment of benefits as required.
Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills.
Verifies insurance coverage for selected services to facilitate cash collection.
Obtains insurance benefit forms and completes as required; obtains signatures and approvals; verifies that information is complete and accurate. Utilizes automated systems to obtain and process information (Registration, Medipac, Blue Cross/HART, Medicare/DDE, Care Choices).
Reviews Face Sheets, Patient Identification Forms and related system reports for accuracy; effect error corrections as appropriate.
Assists patients or physician office staff by referring to the appropriate sources of information.
Identifies opportunities to improve the quality of registration, billing or verification procedures.
Provides patient instructions, directions, and assistance with submission of patient-centered claim submission to insurance carriers.
Explains accounts to patients; translates billing to patient understanding.
Responds to patient questions concerning insurance coverage, benefit coverage for their insurance plans. Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their account. Knows where to obtain information to assist PFS team members, patients, and internal or external customers.
REQUIRED EDUCATION, EXPERIENCE AND LICENSURE
Education:
Requires high school diploma or equivalent.
Experience:
One or two years related experience.
REQUIRED SKILLS AND ABILITIES
Basic knowledge of accounting (debits and credits).
Demonstrated computerized keyboard experience.
Analytical and problem-solving skills.
Effective interpersonal communication skills.
Patience in dealing with ordinary, arduous or emotional patients.
Use of telephones.
WORKING CONDITIONS
Normal office environment.
REPORTING RELATIONSHIPS
Supervision provided by PFS Manager.
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be a complete list of all duties performed.


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