REPRESENTATIVE, PATIENT SERVICES

Description

$2,500 SIGN ON BONUS

Job Summary

Registers patients for the Diabetes Center. Contacts Physician's office to obtain necessary information to obtain an insurance authorization as needed. Contact patient and nursing homes to schedule education. Schedules patient education visits with diabetes educator. Enters charges into STAR.

Essential Job Functions

+ Customer Focus. Assesses customers' needs and considers customer in all decision-making processes to ensure a positive customer experience.

+ Greets the customer in a polite and professional manner whether face-to-face or on the phone, determines needs and responds appropriately and courteously.

+ Responds to customer issues (intra-departmental, inter-departmental, and public) timely and to the satisfaction of the customer.

+ Identifies and performs appropriate action in situations where it is necessary to obtain appropriate documentation for proper advancement through the revenue cycle.

+ Provides constructive feedback and clearly expresses ideas.

+ Interviews patients and/or their representatives in order to obtain accurate demographic, insurance, and claim adjudication information in a timely, courteous, professional manner.

+ Updates system appropriately and accurately, ensuring appropriate signatures are obtained and required authorizations/certifications/medical necessity guidelines are met.

+ Communicates with management all issues that impact the accurate, timely and complete accomplishment of all assigned tasks.

+ Identifies and communicates to management recommendations for process improvement.

+ Readily accepts and incorporates changes into daily activities.

+ Conform consistently to all system changes; including insurance payer regulations.

+ Possess functional knowledge of systems and the revenue cycle in order to adequately assist customers and reduce the unnecessary transfer of work flows.

+ Motivation and Influencing. Influences and persuades others to build commitment to quality and a positive hospital experience.

+ Acts as a role model for peers by striving for excellence, displaying a positive attitude, and actively supporting the team concept.

+ Monitors and reports on individual productivity to assist in the evaluation of one's ability to organize and plan daily work in order to meet outcome-based criteria set by management.

+ Volunteers to work additional hours or offers to contribute to on-going projects/assignments outside the scope of their own specific functions.

+ Fiscal Accountability. Hold self-accountable for departmental processes in order to obtain maximum reimbursement for services and the successful flow of the revenue cycle.

+ Assures proper identification of patients presenting for services following the proper departmental procedures.

+ Maintains accuracy of insurance coverage and guidelines including not but limited to verifying coverage through online eligibility software/insurance web-sites/customer service phone lines; completing Medicare Secondary Questionnaire when required; verifying medical necessity and ABN processes; determining if necessary, authorizations or referrals have been obtained; ensuring each order meets current published standards; etc.

+ Investigates and identifies patient-responsibility dollar amounts in order to successfully collect point-of-service payments when appropriate.

+ Charge posting where applicable when staff is not available timely.

+ Other duties as assigned.

Specialty Functions

+ Regular use and competency in multiple IT systems and software

+ Star

+ IDX

+ Infor

+ Chronicle

+ Microsoft Office and Outlook

+ Patient Scheduling

+ Phone patients and Nursing homes to schedule education

+ Create/manage Star accounts when indicated

+ Create task in Allscripts to alert office when patient unable to be reached

+ Request orders from physician office for education

+ Patient Charge

+ Enter charges into Star

+ Reconcile charges

+ Generate invoices for personal care homes

+ Logistical Support

+ Arrange for rooms to facilitate group education

+ Create attendance certificates for classes

+ Routine faxing/scanning

+ Supportive duties

+ Perform other assigned duties that support operations and revenue cycle within the diabetes center or other outpatient areas.

Required Qualifications

+ High School Diploma, GED or higher level of education.

+ Strong leadership ability, good organizational skills, independent and critical thinking skills, sound judgment, and knowledge of legal aspects.

+ Strong ability to communicate complex and/or controversial topics and concepts to a wide and diverse audience.

+ Medical Terminology.

+ Knowledge of Payor/Insurance Benefits.

+ Proficient Spelling Skills.

+ Knowledge of basic Office Equipment such as copier, fax machine, etc.

+ Ability to communicate with all members of the health care team.

+ Independent thinking and decision-making ability.

+ Ability to multi-task and prioritize assignments.

+ Basic working knowledge of computers and office equipment.

Preferred Qualifications

+ Registration experience in healthcare environment.

License, Certification & Clearances

+ Act 34-PA Criminal Record Check from the PA State Police system

Position Type/Expected Hours of Work

+ Incumbent will be scheduled based on operational need (rotate shifts, standby, on-call, etc.).

+ Travel may be expected locally between System locations.

Equal Employment Opportunity

Independence Health and its affiliated companies are Equal Opportunity Employers. It is their policy to prohibit discrimination of any type and to afford equal employment opportunities to employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, disability, veteran status, or genetic information, or any other classification protected by law. Independence Health and its affiliated companies will comply with all applicable laws and regulations.

Disclaimer

This job description is not designed to contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Moreover, duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Work Environment Effective March 2020 or during pandemic: goggles, face shield and mask are required according to CDC guidelines

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential - Absolute Necessity.

Marginal - Minimal Necessity.

Constantly - 5.5 to 8 hours or more or 200 reps/shift.

Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely - Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Extreme Heat

x

Extreme Cold

x

Heights

x

Confined Spaces

x

Extreme Noise(>85dB)

x

Mechanical Hazards

x

Use of Vibrating Tools

x

Operates Vehicle

x

Operates Heavy Equipment

x

Use of Lifting/Transfer Devices

x

Rotates All Shifts

x

x

8 Hours Shifts

x

x

10-12 Hours Shifts

x

x

On-Call

x

Overtime(+8/hrs/shift; 40/hrs/wk)

x

x

Travel Between Sites

x

x

Direct Patient Care

x

Respirator Protective Equipment

x

Eye Protection

x

Head Protection (hard hat)

x

Hearing Protection

x

Hand Protection

x

Feet, Toe Protection

x

Body Protection

x

Latex Exposure

x

x

Solvent Exposure

x

Paint (direct use) Exposure

x

Dust (sanding) Exposure

x

Ethylene Oxide Exposure

x

Cytotoxic (Chemo) Exposure

x

Blood/Body Fluid Exposure

x

Chemicals (direct use) Exposure

x

Mist Exposure

x

Wax Stripper (direct use)

x

Non-Ionizing Radiation Exposure

x

Ionizing Radiation Exposure

x

Laser Exposure

x

Physical Demands

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Essential - Absolute Necessity.

Marginal - Minimal Necessity.

Constantly - 5.5 to 8 hours or more or 200 reps/shift.

Frequently - 2.5 to 5.5 hours or more or 32-200 reps/shift.

Occasionally - 0.25 to 2.5 hours or 2-32 reps/shift.

Rarely - Less than 0.25 hours or less than 2 reps/shift.

Physical Condition

Essential

Marginal

Constantly

Frequently

Occasionally

Rarely

Never

Bending (Stooping)

x

x

Sitting

x

x

Walking

x

x

Climbing Stairs

x

x

Climbing Ladders

x

Standing

x

x

Kneeling

x

Squatting (Crouching)

x

x

Twisting/Turning

x

x

Keyboard/Computer Operation

x

x

Gross Grasp

x

x

Fine Finger Manipulation

x

x

Hand/Arm Coordination

x

x

Pushing/Pulling(lbs. of force)

x

x

Carry

<5#

5#

Transfer/Push/Pull Patients

x

Seeing Near w/Acuity

x

x

Feeling (Sensation)

x

Color Vision

x

x

Hearing Clearly

x

x

Pulling/Pushing Objects Overhead

x

Reaching Above Shoulder Level

x

x

Reaching Forward

x

x

Lifting Floor to Knuckle

###

x

Lifting Seat Pan to Knuckle

###

x

Lifting Knuckle to Shoulder

###

x

Lifting Shoulder to Overhead

###

x

When lift requirement is in excess of 50#, lift assistance (2 person) and/or transfer device is required.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)