Patient Services Representative

Good Shepherd; Pennsylvania; Hybrid; USD 2,066,000 - 3,444,000; Part time

Job summary

Good Shepherd in Pennsylvania seeks an administrative professional to support clinicians by managing information flow, scheduling patient visits, verifying insurance coverage, and guiding patients through benefits.

Responsibilities include obtaining authorizations, maintaining the EMR, collecting copays, triaging referrals, and protecting patient information with confidentiality and professional courtesy.

Qualifications

• High School Diploma required
• Associate's Degree preferred
• 1-2 years of experience in an administrative position with computer skills required
• Prior health insurance experience preferred
• Basic Life Support / CPR preferred

Responsibilities

• Answering and triaging referral calls and scheduling patient visits
• Collect and verify insurance information and benefits for patients
• Obtain authorizations and manage visit limit tracking in the EMR
• Collect copays and manage payments on a weekly/daily basis
• Maintain accurate patient records and confidentiality of information
• Orient new staff and support team with flexible coverage when needed

Job description

Per Diem , Day / Evening Shift , Variable; as needed

JOB SUMMARY

Enhances clinicians’ effectiveness by providing information management support, which includes answering and triaging phone calls,scheduling patients visits, verifying and securing both initial and ongoing insurance coverage for therapy services, and providing patients with relevant information concerning their insurance coverage.

ESSENTIAL FUNCTIONS

Office Skills

• Demonstrates excellent interpersonal communication skills that translate across the phone, e-mail and in person.
• Effectively and efficiently schedules patients’ initial and follow up visits as needed.
• Assists with answering & triaging referral telephone calls; demonstrates the ability to understand and differentiate between the different types of therapy.
• Collects and verifies insurance information for new and existing patients who have a change in insurance during course of care.
• Attains correct insurance benefit information from insurers.
• Communicates benefits, and potential financial responsibility to patients.
• Collects patient copays at time of service and consolidates payments on a weekly/daily basis based on location.
• Follows up with patients who have out-of-pocket costs.
• Communicates with and resolves patient questions regarding insurance and benefits.
• Obtains authorization for necessary services from insurers for patient
• Performs accurate and timely maintenance of authorization functions, referrals and visit limit tracking in Cerner.
• Prevents disruption of service by securing necessary authorizations prior to the end date after consulting with therapist.
• Researches denials due to authorization or referral issues to determine cause and resolution; resubmits claims after gathering necessary information.
• Assists in obtaining patient satisfaction surveys
• Performs other duties as requested

Documentation

• Accurately utilizes patient EMR system
• Accurately copies record when requested
• Accurately tracks the need for insurance reauthorizations for patients

Team Effort

• Identifies work unit issues & implements solutions
• Orients new staff
• Demonstrates flexibility to help others (provide coverage, adjust work schedule to meet needs)
• Shares knowledge with others
• Embraces change and promotes a positive work environment
• Demonstrates management skills by prioritizing, organizing and completing job responsibilities.

PROTECTS CUSTOMER AND ORGANIZATION INFROMATION

By keeping information confidential, following Good Shepherd’s policy and procedures for release of information, maintaining secure medical records and maintaining security for the contents of the business office.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education

• High School Diploma required
• Associate's Degree preferred

Work Experience

• 1-2 years of experience in an administrative position with computer skills required
• Prior health insurance experience preferred

Licenses / Certifications

• Basic Life Support / CPR, as a healthcare provider, per the American Heart Association preferred

GOOD SHEPHERD'S UNIVERSAL FLU PROGRAM

As a health-care provider, we have a professional and ethical obligation to protect our patients and residents from developing further complications.

GOOD SHEPHERD'S UNIVERSAL FLU PROGRAM

To protect our patients and residents, Good Shepherd requires influenza (flu) vaccinations for all Associates, licensed independent practitioners, contracted, agency and temporary employees, students and volunteers.

***Important Note: Good Shepherd & GSPP Rehabilitation are drug free and tobacco free work environments. As a result, candidates selected for employment may be subject to a drug screen test.***

Good Shepherd is an Equal Employment Opportunity employer and does not discriminate in its hiring or employment practices. All qualified applicants will receive consideration without regard to their race, color, creed, religion, national origin, age, disability, sex, sexual orientation, veteran status or any other characteristic protected by State or Federal law.