Patient Services Representative - Main Hospital

Patient Services Representative

Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.

CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.

A Brief Overview

The Patient Services Representative is responsible for greeting patients and families, collecting and entering demographic and insurance information, collecting payments associated with services rendered and reconciliation of daily services. In addition, other duties necessary to facilitate efficient and timely services to patients and their families, such as scheduling appointments, answering phones, and obtaining appropriate insurance referrals and authorizations as needed per insurance guidelines. Responsibilities may include working with medical records, following HIPAA regulations. Other duties and administrative support and projects as required.

What You Will Do

• Provide welcoming, prompt and respectful customer service which includes scheduling appointments, inform of delays, address family complaints and escalate as necessary.
• Perform EPIC functions such as check in, check out, enter demographic and insurance information while ensuring accuracy, run daily eligibility verifications.
• Reconciliation of daily services to include collection and processing of payments received, reimbursements, create and/or obtain insurance referrals and authorizations needed.
• Answer phones promptly with minimal downtime between calls, accurately verifies and documents contact information and messages, provides appropriate information to callers as warranted. Communicates in a courteous, caring manner to all customers as needed. Check voicemails.
• Call Management Screens callers' reasons for call by using the high priority list and critical thinking skills to prioritize calls to be triaged: backline to nurse, high priority in queue, or regular queue. Triages and documents CHOP home care calls. Contacts on call providers directly for calls from those requesting to speak to them, such as E.D.'s, home care nurses, other physicians, and parents. Assists in the distribution of calls to on call providers when the volume/staffing warrants it. Seeks resources to assist in decision making to ensure safe, high quality telephone triage and customer service as needed.
• Communicates and provides essential information updates during shifts such as change in on call providers and signing out by offices. Communicates concerns and ideas for improvement to the Nursing Supervisor/Manager as needed.
• Perform administrative tasks such as sort and deliver mail, faxes, medical records and other correspondence, photocopies, and faxes documents.
• Participate in team huddles and meetings.
• Daily maintenance of patient records and provider template and daily schedules while following HIPPA guidelines.
• Periodic rounding to inform patients of delays.
• Work necessary billing workques, EPIC pools and various other reports.
• If located in an area where 24/7 coverage is needed, will need to rotate shifts.
• ED/Admissions specific tasks as assigned include: SART paperwork processing, Nurse Call communications, Trauma B-line and arrivals.

Education Qualifications

• High School Diploma / GED Required

Experience Qualifications

• At least one (1) year patient services representative experience in a role that consisted of health care, registration, physician billing, medical records, medical office work and relatable customer service. Preferred

Skills and Abilities

• Good verbal and written communications skills. Good interpersonal skills. Ability to maintain confidentiality and professionalism.

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine.

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly. At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.