Patient Services Representative - GVHP Call Center (Full Time, Day)

NorthBay Healthcare Group; United States; Remote; USD 34,000 - 42,000; Full time

Job summary

NorthBay Health is seeking a Call Center Patient Services Representative to support primary care practices by performing registration, insurance eligibility verification, and detailed message processing for physicians.

The role involves coordinating appointments, confirming demographic data, and guiding patients through payment responsibilities while maintaining confidentiality and high service standards.

Qualifications

• Must have strong organizational and communication skills.
• Experience in healthcare or call center environments is preferred.
• Experience with insurance verification and registration processes is preferred.
• Bilingual ability is a plus.

Responsibilities

• Register patients and enter demographics and insurance information in the practice management system.
• Verify insurance eligibility, co-pays, and financial responsibilities for services rendered.
• Schedule appointments by phone according to provider policies and guidelines.
• Answer inquiries about claims, eligibility and referrals; assist with provider access audits.

Skills

Strong organizational skills

Written and spoken communication

Customer service experience

Bilingual capability

Education

High School Diploma or equivalent

Some college coursework in business or computers

Tools

Practice management systems

CPT/ICD9 coding (beneficial)

Job description

At Northbay Health, the Call Center Patient Services Representative performs general office duties including appointment scheduling, determining and verifying insurance eligibility, and processing of detailed messages to physicians. The Patient Services Representative functions as part of a clerical, clinical, and customer service team in support of primary care practices.

Primary Job Duties

• Registration and Charge Entry
• Gathers, updates and verifies a comprehensive package of registration and insurance/payer information and ensures accurate entry into the practice management system.
• Provides information to patients regarding the selection process for a primary care physician, assists in determining insurance eligibility, co-payments, share of costs and other financial responsibilities for services rendered.
• Verifies and documents eligibility for all payers.
• Reviews benefit plan/s with patient to determine specific allowances and/or restrictions based on services requested.
• Researches and answers inquiries related to claims, eligibility and referrals.
• Ensures the accuracy of demographic and insurance information in accordance with the policies, procedures and service expectations of each department.
• Maintains professional standards by actively participating in committees, inservices and QI activities and standards development.
• Acts as a resource to new and existing staff in personal areas of subject matter expertise.
• Present a professional demeanor in appearance and attitude.
• Floats to other areas as needed.
• Performs other duties as assigned.

Appointments and Reception

• Obtains complete demographic information for new patients ensuring accurate entry into the practice management system. Confirms/updates demographic information for existing patients.
• Confirms eligibility/PCP assignment status for patients with WHA, Health Net or Solano Partnership insurance prior to scheduling appointment.
• Demonstrates effective listening skills to determine appropriate call routing.
• Schedules appointments on the phone in accordance with approved provider protocols and current scheduling policies, procedures and algorithms.
• Monitors provider schedules to ensure appointments are booked for correct type and correct time allocation.
• Places confirmation or rescheduling calls in accordance with scripted guidelines and current policy and procedures.
• Assists in physician schedule maintenance functions including coordination of physician absences with open appointment times.
• Gathers data and performs provider access audits.

Medical Records

• Adheres to System policies related to confidentiality of medical record information, transcription and copies or distribution of medical record content.
• Handles patient documents appropriately to ensure patient confidentiality.

Education

• High School Graduate or equivalent preferred.
• Some college business or computer course work essential.

Licensure/Certification

• AHA BLS certification required within 90 days of hire.
• Course work in medical terminology preferred.

Experience

• 1-2 years working in a healthcare environment required.
• 6 months of direct NorthBay Call Center training/experience can be substituted for healthcare experience.
• 1-2 years direct experience working in a call center environment preferred.
• Strong experience in insurance verification preferred.
• Strong communication skills and dynamic customer service experience preferred.

Skills

• Strong organizational and written and spoken communication skills essential.
• Demonstrated mastery of practice management systems is required with CPT, ICD9 coding experience beneficial.
• Experience in the following areas preferred: appointment scheduling, registration process, insurance verification, primary care preventive care.
• Demonstrated ability to work independently on a variety of complex tasks, managing competing deadlines.
• Bilingual capability preferred.

Standards of Performance

• Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.

Physical Effort

• Attendance is an essential function of the job.
• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee may participate in the following activities.
• Walking, some bending, stooping, and lifting.
• Position requires extensive use of computer keyboarding throughout the day.

Interpersonal Skills and Values

Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.

More Information

Visit NorthBay Health Careers for recruitment FAQsand additional information.