Patient Serv Rep; MHO

Reports to the Manager or Director. Is responsible for the coordination of services for patients at the assigned clinic or site, which includes registration, admitting and discharging patients, scheduling of all new and existing patients, coordinating patients with providers' schedules, contacting payors for authorization/documentation/pre-certification, researching/gathering required outside patient records, and scheduling all ordered imaging and procedural appointments. Duties also include performing a variety of front office tasks, (i.e., greeting customers, answering the telephone, filing, etc.).

Collects applicable co-payments and deductibles and completes insurance verification and must be able to accurately decipher eligibility responses and relay that information back to the patient.

• MISSION:
  We deliver outstanding care, inspire health, and connect with heart.
• VALUES:
  Trust. Respect. Integrity. Compassion.
• SERVICE GOALS:
  Personally connect. Keep everyone informed. Be on their team.

• Scheduling new patients upon physician referral and gathering outside records and imaging as needed with special attention to coordination of care according to disease site.
• Greeting patients upon arrival and accurately completing check in/registration process.
• Admitting and discharging patients, which includes discharging from computer system, completing chart audit form, discharging the patient chart.
• Communicating, verbally, electronically, or in writing with payors to ensure appropriate verification of services and payment.
• Completes check out process with patient after appointment which includes scheduling next appointment and/or scheduling coordinated imaging/procedures.
• Copying patient records and billing when appropriate for insurance companies, attorneys, subpoenas, patients, Vocational Rehabilitation and Disability Determination Board.
• Performing a variety of secretarial duties (i.e., typing, computer, greeting customers, answering the telephone, filing, etc.).
• Coordinating patient visits with the correct paperwork and insurance verification, along with accurate documentation in the patient's medical record is essential.
• Answering high volume of incoming phone calls as well as making high volume of outbound phone calls, with constant communication to the dept clinical team, referring provider offices and Centralized Scheduling department.
• Properly triaging and/or handing incoming patient concerns / phone calls; making sure critical issues are addressed in a timely manner.

Registers Patients (to Obtain Demographic, Physician And Insurance Information In Accordance With Established Departmental Policies And Procedures) And Collects Applicable Co-payments And Deductibles By

• Interviewing patients via telephone for pre-admission or upon presentation for admission in the registration area.
• Obtaining identification, demographic, physician, and insurance information from patients and accurately entering this information into the Hospital financial system.
• Updates system after validation of the new patient's financial information.
• Explaining about the possible need to pre-certify with the patient's insurance carrier to ensure maximum coverage to the limits of the insured's insurance policy.
• Create patient estimate and requests payment either during the pre-registration process or when the patient presents for service in accordance with policies and procedures.
• After collecting applicable co-payments and deductibles, posting patient payments (including cash, checks and credit cards) on the patient's account and generating a system receipt to give to the patient.
• Verifying and documenting insurance coverage via online eligibility systems, internet resources or via telephone.
• Requesting copies of the insurance card(s) and driver's license or other government picture  confirm insurance benefits and identification.
• Validates medical necessity via the MCA Compliance Checker where applicable.
• Completing the MSP (Medicare Secondary Payor) questionnaire by asking the patient the questions based on pt availability.
• Requesting payment…