SJSEMI_Patient Service Rep_R01372

Saint Joseph Mercy Health System - Canton, MI (30+ days ago)4.2


Patient Registration, Account Resolution, Cash Collection, Customer Service

ESSENTIAL DUTIES AND RESPONSIBILITIES
Interviews patients and gathers information to assure accurate and timely claims submission. Interprets information collected to determine and create comprehensive visit-specific billing records. Determines need for and obtains authorization for treatment/procedures and assignment of benefits as required. Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills. Provides assistance to other Health System or physician offices staff regarding registration information and procedures. Determines appropriate payment required at point of registration (deposits, co-pays, minimum charges and non-covered services. Collects payment at time of registration or check-out. Contacts patients to pre-register prior to clinical services. Verifies insurance coverage for selected services to facilitate cash collection. Obtains insurance benefit forms and completes as required; obtains signatures and approvals; verifies that information is complete and accurate. Utilizes automated systems to obtain and process information (Registration, Medipac, Blue Cross/HART, Medicare/DDE, Care Choices). Reviews Face Sheets, Patient Identification Forms and related system reports for accuracy; effect error corrections as appropriate. Responds to problems and questions from Medical Records, Clinical Departments or PFS Teams. Reviews and monitors mainframe error reports (Registration and Medipac 299) and effects corrections. Problem-solves charges, registration data (demographic, insurance) relating to patient inquiries. Demonstrates understanding of prevailing regulatory or 3rd party requirements (MS, pre-certification, consent forms, Advance Directive, etc.). Assists patients or physician office staff by referring to the appropriate sources of information. Identifies opportunities to improve the quality of registration, billing or verification procedures. Provides patient instructions, directions, and assistance with submission of patient-centered claim submission to insurance carriers. Explains accounts to patients; translates billing to patient understanding. Responds to patient questions concerning insurance coverage, benefit coverage for their insurance plans. Demonstrates accountability to follow-up with patients concerning requests for information of action regarding their account. Knows where to obtain information to assist PFS team members, patients, and internal or external customers. Demonstrates team-player abilities and seamless service to patients. Maintains good rapport and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to St. Joseph Mercy Hospital. Discusses patient and hospital information only among appropriate personnel in appropriately private places. Behaves in accordance with the Mission, Vision, and Values of Saint Joseph Mercy Health System. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.

REQUIRED EDUCATION, EXPERIENCE AND LICENSURE

Education:
Requires high school diploma or equivalent.

Experience:
One or two years related experience.

REQUIRED SKILLS AND ABILITIES
Basic knowledge of accounting (debits and credits).
Demonstrated computerized keyboard experience.
Analytical and problem-solving skills.
Effective interpersonal communication skills.
Patience in dealing with ordinary, arduous or emotional patients.
Use of telephones.
WORKING CONDITIONS

Normal office environment.
REPORTING RELATIONSHIPS

Supervision provided by PFS Manager.