PATIENT SERVICES REPRESENTATIVE I

Scope of Job

Responsible for greeting and registering patients in a caring and warm manner, handle in-coming patient telephone calls, scheduling appointments, handling patient queries, collecting and obtaining accurate insurance information, and time of service collections as required.

Description of Duties

• Acts as the first point of contact for patients in the clinical setting and provides high-level customer service consistently to both internal and external customers, while upholding UT Health RGV's mission, values, and promoting service lines.
• Accurately and completely registers patients by obtaining patient demographic information, while maintaining patient confidentiality in according with HIPAA guidelines.
• Responsible for scheduling, rescheduling, and cancelling all patient appointments as needed and when appropriate to maximize patient flow and clinic efficiency.
• Responsible for answering incoming calls in a professional, timely manner, ensuring caller's needs are met and accurate information is relayed and obtained.
• Completes reminder calls as needed; greets incoming patients and visitors in person or on the telephone and promotes active listenings responsively to patient concerns or complaints and provides or seeks appropriate remedies while promoting quality care.
• Check's in and check's out patients through the appropriate appointment workflows, including verifying patient insurance eligibility, scanning all necessary identification into the EMR system, and ensuring completion and accuracy of patient registration forms.
• Performs all necessary daily check-in and checkout tasks as required for reconciliation purposes, including next day preparation of charts, deposit reconciliation, and charge entry.
• Maintains patient confidentiality regarding access to patient and other clinical information via email, computer, fax, and mail.
• Verifies patient insurance eligibility and benefits through various payers, including commercial insurances, Medicaid, and Medicare.
• Obtains the necessary prior authorizations, referrals, and other insurance documentation needed for all visits as required by the insurance carrier.
• Performs all Time-of-Service collections including collecting copays, deductibles, and outstanding balances due on the account.
• Educates the patient/responsible parties regarding billing processes, financial responsibilities, third party benefit information and, provides estimates of out-of-pocket costs to patients.
• Establishes payment plans for outstanding balances and prepayment plans for future services; refers patients to Financial Counselors and screens for charity programs when appropriate.
• Answers frequently asked questions regarding clinic services and appointment related information and is seen as a source of knowledge to both internal and external customers and knows when to escalate questions and concerns.
• Demonstrates respectful, courteous, professional, and appropriate behavior that represents the core values of UT Health RGV and supports the image, mission, and goals of the clinical enterprise.
• May be required to provide coverage at various clinical sites as needed.
• Performs other administrative duties as assigned.

Required Education

High School Diploma or equivalent.

Required Experience

Six (6) months of medical front-office, and/or receptionist experience in patient registration, scheduling, providing customer service, and/or insurance verification and eligibility experience or two (2) years of direct customer service.