Patient Service Representative (PSR) - Pediatrics

Patient Services Representative

Major Responsibilities:

• Greets patients and visitors and responds to routine requests for information. Answers telephone, screens calls, and takes messages.
• Registers patients; obtains demographic and insurance information; verifies insurance coverage, collects co-pays, deductibles, and previous balances; posts payments and updates demographic and insurance information; obtains prior authorizations when needed.
• Schedules patient appointments and coordinates cancellations, reschedules, and additions to schedules. Provides accurate, detailed information regarding test preparations, time patient to arrive, and any other directional information needed by patient.
• Coordinates the scheduling of more complex patient appointments, tests and procedures. Instructs the patient on pre and post-procedure protocols (i.e. medication guidelines, food / beverage consumption guidelines, check-in procedures, directions to facilities, etc.).
• Updates insurance, financial responsibility and other data when changes or additions occur, and communicates to patient as appropriate. Ensures insurance and patient information obtained is complete and accurate, applying acquired knowledge of government and third party payor requirements.
• Identifies, reports, and resolves problems regarding registration or authorizations to appropriate individuals and departments.
• Monitors patient flow to ensure they are cared for in the most efficient and courteous manner. Offers various assistance to patients to include: arranging transportation needs, providing directions, locating wheelchair, etc.
• Performs visit closure including checking out patients after visit, scheduling follow-up appointments, and providing patients with a visit summary.
• May educate patients, staff and providers regarding prior authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance changes or trends.
• Acts as a resource to patient services staff, resolving moderately complex patient concerns. Assists department leadership with orientation and training for patient services staff.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• High School Graduate.

Experience Required:

• Typically requires 1 year of experience in providing customer service that includes experiences in patient scheduling, registration and department / medical clinic reception.

Knowledge, Skills & Abilities Required:

• Excellent customer service skills. Demonstrated ability to effectively act as a resource to other staff.
• Excellent communication (written and verbal) and interpersonal skills; ability to effectively communicate with a variety of patients, staff and physicians.
• Intermediate computer skills including experience in using personal computers; including Microsoft Office or similar applications, and electronic mail.
• Understanding of basic medical terms and abbreviations typically used in the patient scheduling and registration process.
• Training or experience in keyboarding/data entry with an emphasis on speed and accuracy.
• Excellent organizational skills.
• Ability to read and understand verbal and written instructions, and to sort and file information alphabetically and numerically.
• Ability to work in a fast paced environment with a strong attention to detail and accuracy.

Physical Requirements and Working Conditions:

• Exposed to normal medical office environment, may be exposed to potentially ill patients.
• Must be able to sit for extended periods of time.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.