Patient Service Representative Job Description
Patient service representative
provides administrative support to Pediatric Neurosurgeons and nurse practitioners utilizing knowledge of medical terminology and procedures.
Patient Service Representative Duties & Responsibilities
To write an effective patient service representative job description, begin by listing detailed duties, responsibilities and expectations. We have included patient service representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Work with the insurance carriers to ordering and refer Physicians to customers
Completely and accurately process designated pre-authorization orders
Review denials and determine if an appeal/reconsideration is necessary (meets medical criteria, etc), in order to proceed with obtaining authorization prior to billing
Acquire all necessary information, pursuing all avenues to efficiently and effectively complete the order process
Assisting individual policy holders in premium payment submissions and providing options and resolution
Researching and analyzing recurring trends, problems and complaints to determine root cause
Following through with callers when inquiries/issues cannot be resolved on first contact
Contacting brokers and clients on past due premiums to obtain payment commitments and then monitoring these payment commitments
Using “best in class” performance and executing incoming and outgoing communications (phone, e-mail, correspondence) to/from Employer Groups, Third Party Administrators, or Individuals regarding accuracy on invoices, premium payments, outstanding premium balance resolution, and any enrollment issues
Accurate documentation of all correspondence or internal issue and outcome
Patient Service Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Patient Service Representative
List any licenses or certifications required by the position: CPR, HFMA, BLS, CRCS
Education for Patient Service Representative
Typically a job would require a certain level of education.
Employers hiring for the patient service representative job most commonly would prefer for their future employee to have a relevant degree such as High School and Associate Degree in Education, Medical Terminology, General Education, Associates, Medical, Graduate, Technical, Healthcare, Communication, High School Education
Skills for Patient Service Representative
Desired skills for patient service representative include:
Medical terminology
ACA requirements
Commercial and government health insurance and billing guidelines
Understanding of DRG's
Medical ICD9/ICD10 codes and CPT/HCPC Codes and Modifiers
Medical office and terminology
Computerized appointment scheduling system
Insurance processing
Related office functions
PC window applications sufficient to input and retrieve date
Desired experience for patient service representative includes:
Simultaneously logging all inquiries in call tracking system accurately with content and description of question/issue and resolution
Collaborating with matrix internal partners (Sales, Enrollment, Group Installation Teams, Finance, ) to resolve issues and improve process, service, and overall performance as it relates to billing and enrollment
Verifying membership status/eligibility to internal and external customers and providing instruction to customers for submitting enrollment events to CCI
Articulating the company’s operating guidelines along with State, and Federal regulations as it relates to enrollment and premium events
Interacts calmly, respectfully and in a friendly manner with other representatives of services at Immediate Care
Participates in development and implementation of general policies and procedures to provide for the physical and emotional comfort and safety of patients
Patient Service Representative Examples
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Patient Service Representative Job Description
Job Description Example
Our company is hiring for a patient service representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient service representative
- Performs patient account responsibilities
- Performs registration for new patients
- Performs patient and physician scheduling duties
- The Patient Service Representative works in conjunction with providers and clinical staff to take care of patients' administrative needs
- This position is vital to giving the patient the "Patient's First" service and treatment they deserve as soon as they walk into our facility
- This position utilizes our electronic medical record system to verify and update patient demographic information, , posting and balancing of payments collected
- Primary responsibilities include answering the phones, checking patients in and out and general administrative duties
- This position utilizes our electronic medical record system to verify an update patient demographic information, , posting and balancing of payments collected
- Recognizes and uses appropriate patient type for patient registration
- Enters insurance, demographic and other patient information into system
Qualifications for patient service representative
- Practical knowledge of computers
- Minimum two (2) years medical office experience
- Medical office experience with a strong emphasis in customer service, computer skills, and phones or completion of a medical receptionist or equivalent training program
- OB/GYN clinic experience a plus
- Computer Keyboarding 40 words per minute
- Organizational skills, attention to detail, and the ability to work independently
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Patient Service Representative Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of patient service representative. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for patient service representative
- Notifies patients of lab results after direction from the RN
- Coordinates delivery of medication and supplies to patients to ensure timeliness of dosing
- Reviews supply inventory with patient for completeness and accuracy of use according to the IV policies of CCHC
- Documents requests for refill per CMS guidelines
- Communicates supply usage issues to home nursing staff and works with nurses, pharmacists and pharmacy techs to
- Ensure appropriate inventory
- Schedules equipment exchange according to the preventative maintenance calendar as outlined by the manufacturer
- Maintains active patient roster
- Maintains patient and equipment records in accordance with regulatory guidelines as outlined by JCAHO, CMS
- Participates in company performance improvement activities
Qualifications for patient service representative
- Coordinates with SJH HIM department to release medical records
- Participates in Craneware denials for billing/reimbursement/revenue cycle processes
- Assists Imaging Manager in hiring processes and performance evaluations for front-end staff
- Courteous interaction with all customers and co-workers
- Supports and promotes the values and mission of the organization
- Position is primarily seated at a desk using telephone, keyboard, and PC
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Patient Service Representative Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of patient service representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient service representative
- Other areas of responsibility may include answering telephones, daily maintenance voicemail retrieval and accurate message transcription and follow through, distribution of mail, and clerical duties as assigned
- Greet patients in a friendly manner and acknowledge patient concerns or issues
- Copy insurance card
- Remind patients of their co-pays at time of check in and/or collect
- Assemble charts for all new patients
- Provides a welcoming presence at all entrances
- Seeks to understand the needs of the internal and external customers
- Assisting clinicians with front office duties as required
- Complies with privacy and confidentiality policies when communicating with callers and guests
- Answers phones for prescription refills
Qualifications for patient service representative
- May be required to lift
- May be required to escort patients to location of care using wheelchair transport
- Ability to type 30 words per minute with 0-2 errors
- Receptionist or equivalent training program
- Knowledge of eye insurance health plans
- General knowledge of medical office procedures and terminology
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Patient Service Representative Job Description
Job Description Example
Our company is hiring for a patient service representative. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for patient service representative
- Position may involve work at additional locations including Lutheran Hospital, Lakewood YMCA, and Fairview Gemini Recreation Center
- Notify appropriate of department on patient arrival or appropriate personnel immediately of all exams
- Verify/update changes in patient/physician/insurance information to ensure proper billing
- Calls next day patients to confirm appointments
- Obtains patient signatures on all pertinent forms
- Obtains proper authorization prior to release of confidential medical information
- Accurately message or transfers call to physicians and nurses when protocol indicated
- As appropriate accepts electronic payments
- Answer/transfer incoming phone calls
- Enter accurate information in the system
Qualifications for patient service representative
- Effective interpersonal and customer relation skills
- Basic computer operating knowledge required
- One year of office experience highly preferred
- Evening shift coverage required, minimum of 2 evenings per week up to 7pm
- Travel and coverage at various locations required
- PSRs must be competent and knowledgeable of duties within the medical office setting which may include filing, answering the telephone, patient registration, posting payments, charge entry, scheduling, third party payers requirements, ICD-9 & CPT coding, medical records processing, patient contact, transcription, and assists other personnel and physicians in all departments as needed
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Patient Service Representative Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of patient service representative. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for patient service representative
- Obtain proper authorization and identification prior to release of confidential medical records
- Use clerical skills
- Answer telephones within three rings, prioritize calls and coordinates service
- Greets all patients with a warm and welcoming tone
- Demonstrates effective communication using AIDET techniques on every call
- Assist patients in understanding account balances
- Handle calls, resolving patient issues independently and in real time whenever possible
- Creates a positive patient experience at every encounter, attempting to resolve any issues or concerns of the patient at the time of the phone call within the scope of the role
- Provides outstanding and compassionate care and service, every step along the way, fostering teamwork
- Consistently meets productivity, schedule adherence and quality standards as set by management
Qualifications for patient service representative
- Must stand/walk/bend to retrieve documents from printer, file, and use copier
- Medical Assistant or Associate degree in nursing preferred
- Two years front office medical experience required with a strong emphasis in customer service, computer skills, and phones or completion of a medical receptionist or equivalent training program
- 3 years related healthcare, registration, physician billing, medical records and/or medical office experience preferred
- Previous customer service background required
- Human Arc's operating systems