Patient Service Representative

CommonSpirit Health; Santa Cruz (CA); On-site; USD 51,000 - 57,000; Full time

Job summary

Dominican Hospital in Santa Cruz, CA, seeks a Patient Service Representative to ensure accurate entry of insurance data at service or during pre-registration. You will verify benefits for scheduled admissions, outpatient services, and urgent admits within 24 hours where possible.

You will obtain verifications, referrals, authorizations, and pre-certifications, document liabilities, and collect co-pays and deductibles. HIPAA and PHI must be protected.

Qualifications

• Minimum one year in a hospital Patient Registration or related revenue cycle role.
• High school diploma or GED required.

Responsibilities

• Enter insurance information accurately into the legacy system.
• Verify benefits for scheduled, outpatient, and urgent admissions.
• Obtain verification, referrals, authorizations and pre-certifications.
• Document financial responsibilities and collect co-pays and deductibles.
• Comply with HIPAA and protect PHI during registration processes.
• Act as a resource to other hospital departments on benefits and requirements.

Skills

AIDET communication

HIPAA compliance

Insurance verification

Customer service

Education

High School Graduate General Studies

High School GED General Studies

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

Pay Range

$36.76 - $41.73 /hour