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Patient Service Representative

Patient Service Representative

The Center for Orthopedic and Research EPhoenix, AZ, US
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Job Description

Job Description

At The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following :

  • Competitive Health & Welfare Benefits
  • Monthly $43 stipend to use toward ancillary benefits
  • HSA with qualifying HDHP plans with company match
  • 401k plan after 6 months of service with company match (Part-time employees included)
  • Employee Assistance Program that is available 24 / 7 to provide support
  • Employee Appreciation Days
  • Employee Wellness Events

Qualifications

  • High school diploma / GED or equivalent is required.
  • 1–2 years of experience in a hospital, medical office, or customer service setting (preferred).
  • Familiar with and understand Medicare, Medicaid and other government payors and HMO / PPO payors guidelines and principals.
  • Understands benefits (i.e. : deductibles, copays, and coinsurance) and how to calculate estimates per the payor contract as applicable.
  • Previous patient registration in a medical office, hospital or outpatient surgery center.
  • Medicare, Medicaid and other government payor guidelines.
  • Clear understanding of insurance benefits and how to calculate patient responsibility.
  • Knowledge of Patient Registration.
  • Strong customer service and communication skills.
  • Ability to communicate patient responsibility clearly with patients, communicate with physician’s office staff, payors and hospital teammates.
  • Ability to resolve issues in a professional manner.
  • Ability to work independently with minimal supervision.

    • Essential Functions

  • Greet patients, families, and visitors in a courteous and professional manner.
  • Answer and route incoming patient calls promptly and professionally.
  • Maintain a clean and organized front desk area.
  • Maintain confidentiality and compliance with HIPAA and hospital policies.
  • Assist with other clerical or administrative tasks as assigned.
  • Maintain a clean and organized work environment and ensure supplies are stocked.
  • Collaborate with other departments to ensure smooth patient flow and timely service.
  • Initiate and announce overhead emergency codes, including "Code Red" in the event of fire or smoke detection, following facility procedures.
  • Respond calmly and appropriately to emergency situations, including notifying security and / or emergency response teams.
  • Collect and verify patient demographics, insurance information, and required documentation.
  • Input accurate patient data into the hospital EMR system.
  • Prepare patient charts in advance of scheduled appointments to ensure all required documentation is complete and accurate. Include all necessary forms , such as consent forms. Patient Estimate Letters and procedure-specific paperwork
  • Obtain patient signatures for consent forms, insurance authorizations, and privacy acknowledgments.
  • Provide patients with information on hospital policies, procedures, and financial responsibilities.
  • Coordinate with clinical and billing departments to ensure proper patient flow and documentation.
  • Respond to patient and visitor inquiries and resolve registration issues efficiently.
  • Confirm and document insurance information to reduce the risk of claim denials.
  • Explain financial responsibility to patients when appropriate.
  • Accept and process payments for co-pays or deposits, when necessary.
  • Be familiar with individual payor guidelines and the process of collecting over the counter payments / deductibles / co -pay / coinsurance. Knowledge of payor contracts including Medicare, Medicaid and other government contracts and guidelines.
  • Investigate questionable information promptly, i.e. MVA and work comp information that conflicts with insurer information.
  • Notify Business Office Manager and Physician Office of any benefit, financial or authorization concerns or issues immediately.
  • Work two weeks ahead of surgeries to avoid late notice cancellations.
  • Contact patients in advance of their scheduled imaging appointments to provide information about their financial responsibility (e.g., co-pays, deductibles, self-pay estimates).
  • Review and explain out-of-pocket costs clearly and answer any patient questions regarding their financial obligation.
  • Work with patients to establish payment arrangements prior to their arrival, including setting up payment plans when appropriate and in accordance with organization policy.
  • Document all financial discussions and agreements and save this information in the appropriate system or shared folder for team access.
  • Ensure all payment plans are properly recorded and accessible to staff and billing teams to avoid confusion
  • Review entered information with patient to ensure accuracy.
  • Scan photo identification and insurance card(s) into EMR. Make any corrections to insurance information upon review of insurance card(s) when necessary.
  • Request Living Will / Advance Directives. Provide information if requested on where to obtain information on said forms to patient. Document when patient requests information and that it was provided in order to meet state and Joint Commission requirements.
  • Complete Medicare MSP questionnaire when necessary.
  • Collect patient responsibility upon admission.
  • Obtain patient signature on required forms.
  • Print labels and wristband and Facesheets. Review patient information with the patient and confirm accuracy after applying the wristband. Take chart with labels to Pre-op to notify nurses that patient is registered.
  • Meet or exceed monthly, quarterly and yearly cash collection goals.
  • Discusses patient information with other health team members in an appropriate environment.
  • Interacts with all patients, families, visitors and fellow teammates in a mature, responsible manner to ensure a positive and professional facility environment.
  • Must have a clear understanding of KPI and Metric’s measures and ability to complete daily tasks to meet Departmental and Hospital measures.
  • Schedule, reschedule, and cancel imaging appointments as needed
  • Communicate prep instructions for various imaging procedures (e.g., MRI, CT, X-ray)
  • Coordinate with imaging technologists and other departments to ensure proper patient flow
  • Verify imaging orders to ensure all information is accurate, complete, and matches the scheduled exam (e.g., exam type, body part, laterality, clinical indications).
  • If discrepancies or missing information are identified, follow established procedures to contact the ordering provider or their office to obtain a corrected or updated order .
  • Ensure all orders are finalized and properly documented in the patient chart prior to the appointment to avoid delays in care and ensure compliance with regulatory requirements.
  • Contact patients in advance to confirm their upcoming imaging appointments.
  • Verify appointment details including date, time, location, and type of exam.
  • Provide patients with any necessary preparation instructions (e.g., fasting, medication restrictions) specific to their imaging procedure.
  • Address any patient questions or concerns and ensure they understand check-in procedures and arrival time expectations .
  • Document confirmation in the appropriate system or communication log.
  • Other duties as assigned.
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