Patient Svcs Rep - Outpatient Rehab - Austell, GA (Full-Time)

This job is typically the first point of contact and must ensure a pleasant compassionate and empathetic experience for patients and visitors. The Patient Representative interviews patients and/or their representatives to obtain complete and accurate demographic, financial and insurance information, required for billing and collecting patient accounts.

• Conducts intensive screening of all worker's compensation, Medicare, Medicaid and managed care patients for pre-certification requirements and provider service eligibility, prior to registration as applicable.
• Obtains all necessary customer consents/attestations.
• Maintains a working knowledge of insurance benefits and coverage verification.
• Coordinates the collection of estimated patient liabilities, including co-payments when applicable.
• Responds to customer requests and answers questions regarding various service and account information.
• Analyzes and rectifies customer concerns using established procedures.
• Uses computer to access and/or update customer confidential patient records.
• Answers multi-line phone system, registers returning and new patients accurately, prepares patient paperwork, verifies commercial and government insurances, understands the breakdown of insurance benefits and when authorization may be required per payor requirements.
• Reviews insurance benefits with patient; detail oriented to accurately update and maintain data entry into spreadsheets.
• Maintains inventory of supplies and orders when necessary.
• Understands and works in EPIC and OP Rehab EMR System.
• Reviews and accurately verifies and posts payments through EPIC and OP Rehab EMR.
• Follows WellStar and PAS policy for processing receipts, cash, and end of day closing of cash drawer.
• Effectively sorts, organizes, and maintains various documents to support front office functions and procedures.
• Refers patients to financial counselor to establish financial arrangements to reduce financial risk for WellStar.
• Receives requests for appointments from physician's offices and/or employers and makes the necessary pre-admission arrangements.
• Greets all guests with a positive and professional attitude.
• Arranges to have patients escorted to procedure areas and/or assigned rooms.
• Maintains confidentiality of patient information in accordance with WellStar policy and HIPAA regulations.
• Answers incoming phone calls and routes to appropriate parties or addresses issues as directed.
• Assists physicians and their office staff as well as patients to expedite scheduling, pre-registration, pre-certification and/or prior authorizations.
• Maintains courteous and cooperative working relationships with patients/families, co-workers, management, physicians, other professionals, and the general public.
• Completes registration process per WellStar policy and regulatory standards.
• Interviews each patient or representative in order to obtain complete and accurate demographic, financial and insurance information, and accurately enters all patient information into the registration system.
• Reads physician's orders to determine services requested and to assure order validity.
• Obtains new medical record numbers for all new patients.
• Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by patient's third party payor.
• Documents thorough explanatory notes on patient accounts concerning any non-routine circumstances clarifying special billing processes.
• Re-verifies all information at time of registration process.
• Works with IT/EMR on troubleshooting Registration interface errors.
• Assists in verifying benefits as needed and all patients end of year.
• Completes all revenue collection efforts according to WellStar and PAS policy.
• Contacts patients prior to initial visit to discuss co-pay and/or self-pay arrangements.
• Collects the co-pay amount at each visit and provides a receipt to the patient.
• Balances collection log and receipts at end of each business day.
• Explains prompt payment discount policies to self-pay patients.
• Routes self-pay patients to financial counselor for financial arrangements of self-pay balances, as indicated.
• Makes corrections and updates patient account information in computer as necessary.
• Documents concise and understandable notes regarding self-pay and co-pay collection activity as indicated.
• Timely communicates on all charge addendums.
• Works efficiently and accurately within designated time frame to ensure a continuity of information and patient flow.
• Prepares charts for the clinic in a timely manner.
• Consistently demonstrates the ability to organize work, recognize and establish appropriate work priorities, and complete work in a productive manner, without creating backlogs.
• Maintains proficiency and accuracy in data entry skills.
• Maintains a working knowledge of available information system capabilities and performs all system applications that are required.
• Faxes, mails or otherwise provides medical information to referring physicians in a timely manner, as per departmental process.
• Accurately provides information to medical record company as requested for review of claims, as per departmental process.
• Effectively utilizes and daily maintains all office equipment, phone system and intercom system and PC.
• Keeps management (Lead PSR, Clinic Supervisor, Admin) informed of all necessary information; reaches out for assistance as needed.
• Tracks financial/clinical statistical data as per departmental requirements, and functions in a clerical support role for department.
• Works EPIC work queues and reports daily per demands.
• Analytical skills to effectively complete all denials in a timely manner, collaborating with other departments as needed.
• Prepares and maintains accurate statistics consisting of visits, new patients, procedures, revenue, patient satisfaction, etc. for the department.
• Submits daily, weekly and/or monthly reports of statistical information to administration.
• Utilizes Lawson or other method appropriately to maintain departmental ordering/inventory process.
• Provides secretarial support to manager and clinical staff in a timely manner, maintaining appropriate confidentiality.
• Records and maintains minutes of monthly departmental meetings.
• Maintains educational records for department, including entering educational information into Kronos Timekeeper.
• Creates charts, forms, reports and other documents on PC.

Required Minimum Education

High school diploma or equivalent

Required Minimum Experience

Previous employment record reflects work stability, as indicated by an average work tenure for previous jobs of at least one (1) year. Minimum 2 years of related experience in healthcare work setting, with exposure to front office responsibilities, insurance verification and insurance authorizations preferred.

Required Minimum Skills

Typing and data entry competency; work with minimal direction after training; basic computer skills; insurance terminology and knowledge, pre-certification/authorization process, medical terminology and ICD 10 knowledge preferred; familiarity with routine office equipment and Microsoft Office. Demonstrated professionalism, effective communication skills and active listening.