Patient Service Specialist PR - Outpatient Rehab

Patient Service Specialist Patient Relations

The Patient Service Specialist Patient Relations ensures the Mission/Vision and financial integrity of Health First, Inc. by achieving sustainable levels of internal and external customer service, regulatory compliance, and financial performance within the revenue cycle.

Primary Responsibilities

1. Prepare charts for scheduled patients, obtain and verify authorizations, perform medical necessity, and ensure accurate orders are in place for all service lines.
2. Register patients by using two patient identifiers (name, date of birth, etc.), confirm armband accuracy, input demographics information, and secure the required forms to meet compliance with regulatory policies.
3. Perform Medicare compliance review on all applicable Medicare accounts in order to determine coverage. Identify patients who may need Medicare Advance Beneficiary Notices of Noncoverage (ABNs). Issues ABN forms as needed.
4. Complete Medicare Secondary Payer Questionnaire (MSPQ) for Medicare beneficiaries.
5. Verify insurance eligibility and benefits through eligibility systems or contacts insurance companies by phone, fax, online portal, and other resources to determine extent of coverage within established timeframe before scheduled appointments and during or after care for unscheduled or emergent patients.
6. Calculate patients' co-pays, deductibles, and co-insurance. Provide patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service for both emergency and outpatient services.
7. Attempt to collect patient cost-sharing amounts (e.g., co-pays, deductibles) and outstanding balances prior to service and post payments.
8. Ensure compliance with state and federal laws regarding all aspects of role.
9. Proficient and able to function in all Registration environments.
10. Mentor staff and assist with training new staff on department specific procedures and applications.
11. Daily reconciliation of payment collections, preparation of bank deposits, and petty cash distribution.

Work Experience

Minimum Qualifications

• Education: High School diploma or equivalent.
• Work Experience: 1 year customer service experience.
• Knowledge/Skills/Abilities: Working knowledge of Microsoft Office applications, organizational and communication skills, excellent customer service skills.

Preferred Qualifications

• Certification: CPR Certification.
• Knowledge/Skills/Abilities: General knowledge of healthcare terminology and abbreviations, previous healthcare experience.

Physical Requirements

• Majority of time involves sitting or standing; occasional walking, bending, stooping Long periods of computer time or at workstation.
• Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
• May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise.
• Communicating with others to exchange information.
• Visual acuity and hand-eye coordination to perform tasks.
• Workspace may vary from open to confined.
• May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.

About Health First

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Schedule: Full-Time