Patient Service Rep

SUMMARY:

The Patient Service Representative reports to the Cardiac Testing Manager and ensures the efficient management of patients seen for cardiac diagnostic testing including answering patient phone calls, registering patients and checking coverage eligibility, making appointments, and ensuring that all payer authorizations have been obtained.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

Instill Trust and Value Differences
Patient and Community Focus and Collaborate

RESPONSIBILITIES:

Triages and tracks telephone contacts; directs calls to appropriate party. Monitors status of phone messages to ensure complete follow-through.

Obtains patient registration information upon initial telephone contact.

Courteously and accurately completes patient registration form/screen during initial telephone contact.

Schedules patient appointments to ensure a timely and efficient flow of patients; confirms patient appointments as required. Reschedules as necessary, tracks missed appointments.

Reviews the automated patient confirmation lists to identify patients that have cancelled and notifies the appropriate staff.

Verifies insurance eligibility of testing patients.

Confirms that insurance coverage requirements are met prior to the patient's arrival. Confirms that all necessary ICD-9 codes are in place.

Obtains necessary authorization number according to third party payer requirements.

Ensures that the appropriate referrals are obtained prior to scheduling of appointment.

Reviews the daily schedules to confirm that the data are accurate and complete prior to the patient's arrival.

This includes the written order and prior test results. Obtains and verifies all financial information to ensure accuracy and completeness of all necessary forms.

Maintains knowledge of procedures for new and established patients.Ensures appropriate forms, such as insurance and/or consent, are completed as mandated by federal or state authorities.

Creates and maintains the patient record.

Registers patients upon arrival in the office, verifying complete and accurate demographic and insurance information. Requests appropriate patient identification. Obtains a copy of current insurance card and may collect co-payment.

May post co-payment as per procedure.

Maintains patient flow in waiting room to ensure prompt processing of all patients; notifies medical staff of patient arrival.

Communicates with testing staff regarding changes to the daily testing schedules. Assists the professional staff as necessary to provide patient care.

Works to assist other staff members with diagnostic test scheduling.

Communicates with employees regarding testing appointment availability.

Assist other staff members in all areas including, but not limited too, chart prep, filing, QA, and special projects.

Sends reports to referring physicians as needed.

Depending on assignment may work with the hospital cardiac catheterization departments and the cardiac electrophysiology departments to ensure that insurance requirements for procedures have been met.

Communicates with patients, physicians, and third part payers to facilitate payment of services as necessary.

Stays informed of third party payer requirements and educates other staff members of these changes.

Works with the Cardiac Testing manager to modify authorization procedures based on authorization changes.

Maintains quality assurance, safety, and environmental and infection control in accordance with established policies and procedures.

Protects and preserves the patient's right to privacy and confidentiality.

MINIMUM QUALIFICATIONS:

BASIC KNOWLEDGE:

Thorough understanding of cardiac diagnostic testing procedures.

Understanding of medical terminology and medical billing processes.

Demonstrated knowledge and skills necessary to communicate with patients and to ensure that their needs are met efficiently. Basic computer and organizational skills

.EXPERIENCE:

Two years' experience in health care environment.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Outpatient medical practice office environment.

Works with office equipment and has direct patient contact.

Any potential hazards are minimized by adherence to established safety procedures and precautions including use safety equipment and protective clothing.

Walks and stands intermittently throughout the day.

May be exposed to electrical and energy hazards.

SUPERVISORY RESPONSIBILITY: None.

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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Driving Required: