Patient Service Representative

Dominican Hospital; Live Oak (CA); On-site; USD 42,000 - 65,000; Full time

Job summary

Dignity Health - Dominican Hospital in Santa Cruz, CA seeks a Patient Service Representative to ensure accurate entry of insurance data and verification of benefits at registration or admission.

You will obtain referrals, authorizations, and pre-certifications, document all details in the legacy system, and communicate financial responsibilities to patients while adhering to HIPAA and PHI regulations.

Qualifications

• High School diploma or GED required.
• Experience in hospital patient registration or revenue cycle roles preferred.

Responsibilities

• Enter insurance information accurately into legacy system at admission or pre-registration.
• Verify insurance benefits for scheduled admissions, outpatient services, and urgent/emergent admits within required timelines.
• Obtain insurance verification, referrals, authorizations, and precertifications; document in system and communicate financial responsibilities to patients.

Skills

AIDET communication

Education

High School Diploma/GED

Job description

Job Summary and Responsibilities

As our Patient Service Representative, you will ensure complete, accurate and timely entry of insurance information into a legacy system, either at the time of service or during pre-registration/pre-admission. You will verify insurance benefits on all assigned scheduled admissions and outpatient services. You will also verify insurance benefits on all urgent/emergent admits within 24 hours of service.

Every day you will obtain insurance verification, referral, authorization and pre-certification, and document this information into the legacy system. You will verify patient liabilities by using electronic verification systems during pre-registration. You will determine patient financial responsibilities at the time of service and collect co-payments, deductibles, or co-insurance.

To be successful in this role, you will utilize the AIDET principle to communicate with others, with a focus on patients and their families. You will provide clarification of the division of financial responsibility to the patient, and document it in the system. This includes complying with HIPAA, PHI, and its implications, and other regulations which affect the registration process. You will act as a resource to other hospital departments on insurance benefits and requirements.

• Utilizes the AIDET principle to communicate with others, with a focus on patients and their families. Acknowledge Introduce Explain Duration Thank
• Ensures complete, accurate and timely entry of insurance information into legacy system, either at the time of service or during pre-registration/pre-admission.
• Verifies insurance benefits on all assigned scheduled admissions and outpatient services, at least 3 days prior to date of service when possible, by using electronic verification systems.
• Verifies insurance benefits on all urgent/emergent admits within 24 hours of service (or next business day) by using electronic systems.
• Obtains insurance verification, referral, authorization and pre-certification, and documents this information into the legacy system and submits notices of admission, where necessary.
• Verifies patient liabilities by using electronic verification systems during pre-registration, where possible.

Job Requirements

Required

• High School Graduate General Studies; or
• High School GED General Studies; and
• Minimum one (1) year of experience working in a hospital Patient Registration department, physician office setting, healthcare insurance company, revenue cycle vendor, and/or other revenue cycle related roles; or

Preferred

• Other Applicable education and/or training can be used in lieu of lack of experience.
• 2 years experience preferred.

Where You'll Work

Founded in 1941, Dignity Health - Dominican Hospital is a 188-bed, acute care, nonprofit hospital located in Santa Cruz, California. Serving over 80,000 patients annually, the hospital offers a full complement of services including heart care, orthopedics, and a Family Birthing Center. Additionally, Dominican Hospital has been recognized as an LGBTQ+ Healthcare Equality High Performer by the Human Rights Campaign Foundation. It is a Joint Commission-certified Primary Stroke Center, and has been awarded the AMA/ASA’s Get the Guidelines - Stroke Gold Plus Quality Achievement, recognizing the hospital’s commitment to providing the best stroke care.

One Community. One Mission. One California