Patient Financial Services Representative-General Surgery-FT-Days-MPG

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary:

The Patient Financial Services Representative (PFSR) serves as the first point of contact in greeting patients and guarantors in the hospital, ambulatory or medical office setting. The PFSR engages with the patient or guarantor to obtain pertinent information and answer any questions in an effort to ensure that all required demographic, financial, and insurance eligibility information is gathered and verified. Ensures all required notices and consent forms are signed accordingly.

Responsibilities:

Follow-up on reported issues and assist with service recovery.Verifies insurance benefits and obtains pre-certification/authorization as necessary. Determines and accepts required payments, including co-pays and deductibles, or refers to financial counselors for follow up.Ensure daily patient appointment reminder calls are complete. Appointment no-Shows are contacted and patients are rescheduled following practice guidelines. Accurately document telephone encounter outcomes.Checks Incoming Referral work ques daily and contacts patients to schedule requested appointment.Activates of My Chart Accounts where appropriate. Ensures Telehealth connectivity for scheduled appointments and trouble shoots as needed.Meet with patient or patient's caregiver to discuss appointment instructions, and discuss patient's concerns.Communicates with referring physician's office, clinical department(s), and/or other appropriate personnel to exchange necessary information and determine schedule.Work through incoming departmental referral work queues daily.Daily review and monitoring of physician / practice schedules keeping no-show rates low to ensure patient access.Ensures that all necessary demographic, billing, and clinical information is obtained and entered in the registration system with timeliness and accuracy.Round with patients in practice to ensure Excellent Patient Experience is met.Process medical record requests.

Competencies:

ACCOUNTABILITY, ACCURACY & QUALITY, CUSTOMER SERVICE, ORGANIZATION SKILLS, PATIENT ACCESS, PATIENT AND FAMILY CENTERED CARE, PROBLEM SOLVING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, VERIFYING INSURANCE

Education and Certification Requirements:

High School Diploma or Equivalent (Required)

Additional Job Information:

Complexity of Work: Requires excellent communication skills, critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Ability to work and build relationships collaboratively. Required Work Experience: No experience required. One (1) year of related hospital, medical office, or customer service experience preferred. Other Information: In Memorial Physician Group (specialty practices), additional responsibilities include: (1) obtain specialty authorizations (2) authorization denial and peer to peer process (3) patient care navigation ex: surgical and procedural coordination and scheduling for patient specific populations (4) handle all incoming calls and physician and hospital back line (5) obtain and confirm referralsIn the Hospital, additional responsibilities include: (1) Upon validation of patient identity, place identification band on patient (2) obtain signatures for hospital specific regulatory forms not required in an ambulatory or office setting (3) obtain authorizations for walk-in appointments (4) determine when financial assistance is needed.In Memorial Primary Care, additional responsibilities include: (1) MIH-MPC program patient referral, payment collection and eligibility scheduling (2) process referral work-ques and same day access requests (3) work with Patient Access Center on real time patient requests (4) address prescription refill requests, patient advice requests through MyChart, and provider scheduling template.

Working Conditions and Physical Requirements:

•  Bending and Stooping = 60%
•  Climbing = 0%
•  Keyboard Entry = 100%
•  Kneeling = 0%
•  Lifting/Carrying Patients 35 Pounds or Greater = 60%
•  Lifting or Carrying 0 - 25 lbs Non-Patient = 80%
•  Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 40%
•  Lifting or Carrying > 75 lbs Non-Patient = 0%
•  Pushing or Pulling 0 - 25 lbs Non-Patient = 80%
•  Pushing or Pulling 26 - 75 lbs Non-Patient = 80%
•  Pushing or Pulling > 75 lbs Non-Patient = 0%
•  Reaching = 80%
•  Repetitive Movement Foot/Leg