Patient Service Representative

Description

JOB SUMMARY:

Reports directly to the Clinic Administrator (CA) and is responsible for providing pleasant customer service while interviewing, screening and assisting patients with issues and concerns, such as but not limited to completing applications, determining their ability to pay, assessing insurance needs and enrolling them with the appropriate insurance/plan provider(s).

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Upholds and supports the mission, philosophy, objectives, policies and ethics of Community Health Systems, Inc. (CHSI).
• Responsible for participating in quality improvement projects/activities and accountable for quality and PCMH.
• Provides health insurance benefit information and assists patients and families in applying for health insurance benefits.
• Conduct a confidential interview with patients and families to compile information on financial standings against current Federal Poverty Guidelines (FPG) for eligibility in applying for Sliding Fee Scale (SFS) program.
• Registers patients by verifying that patient's record is up to date and accurate. Makes appropriate changes in electronic medical record.
• Complies with federal and local laws in ensuring patient privacy.
• Informs patients and families of services provided by CHSI.
• Collects payment from patients, applies payments and adjustments to patient account(s) and reconciles daily cash reports.
• Track and prepare reports for management concerning visits with patients
• Serve as a liaison between patients, family services, and insurance companies.
• Follow-up with families to ensure they receive benefits and return to the clinics for healthcare needs.
• Will work closely with the Outreach Department.
• Perform all other duties as directed either formally or informally, verbally or in writing.

SUPERVISORY RESPONSIBILITIES:

There are no current supervisory duties required.

KNOWLEDGE, SKILLS AND ABILITIES:

• Bilingual (English/Spanish) preferred.
• A high standard of professionalism and professional ethics and conduct is expected in speech, manner, attitude and appearance at all times.
• Possess strong interpersonal skills and ability to work well with others.
• Ability to deal effectively with changing situations and stressful environment.
• Knowledge of current insurance programs for low-income, underinsured individuals and families. • Ability to seek out other insurance programs that will serve the patients in the community.
• Ability to read and interpret documents such as tax forms, immigration paperwork, etc. • Possess basic mathematical skills (i.e. percentages and fractions).
• Strong computer skills, with proficiency in Microsoft Office.
• Possess strong customer service skills in both written and verbal communication, with the ability to interact and negotiate with co-workers, management, vendors and others as necessary.
• Ability to perform tasks related to physical activity to complete the responsibilities of the position.

EXPERIENCE AND EDUCATION:

• High School Diploma or GED required
• Associate's degree (A.A.) or equivalent from two-year college or technical school; OR 2+ years related experience and/or training; OR equivalent combination of education and experience.
• Certified Enrollment Counselor (CEC) required (within 90 days of hire dependent on training availability)