Patient Services Representative - NBGW ENT (Full Time, Day)

At Northbay Health, the Patient Services Representative III is responsible for scheduling surgeries and referrals, in coordination with the care team. They also promptly assist patients with their financial clearance prior to, during, or after their treatment period. This position is responsible for obtaining and updating insurance, financial, and demographic information. Courteously and professionally helps patients and/or their families understand and assist with options to cover their financial obligations including but not limited to: co-pays, deductibles, and co-insurance. Responsible for establishing payment plans and collecting true self-pay and self-pay residual balances as necessary. Responsible for assisting patients with ad-hoc financial issues as needed prior to, during and following their treatment. Offers financial advice and assistance to patients regarding medical bills. They are the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties. Their job is to handle financial obligations so that patients and physicians can focus on healthcare. Primary Job Duties May provide cost estimates for outpatient and inpatient care. Educate patients about payment options and financial assistance. Negotiates and strategize patient payment arrangements. Update patient accounts and balances. Review and process patient and insurance company forms. Communicate with patients, insurance company, Ambulatory Surgery Center Scheduler, and OR Scheduler on the phone. Coordinates with surgeons care to in scheduling elective and non-elective surgeries in the Ambulatory Surgery Center & OR. Informs and/or updates supervisory personnel of any patient billing concerns. Answers all patient billing questions and works with ambulatory accounting or insurance companies to correct patient billing errors. Communicates and collaborates with other departments to provide continuity of care across departments and disciplines. Assists PSRs with their workload, and gives support as needed. Schedules referrals for orthopedic providers in clinic. Consistently demonstrates and promotes a sense of team within the immediate and extended work groups, and maintains effective communication with all external and internal customers. Works on special projects and/or interdisciplinary committees as assigned. Other duties as assigned. Education : High School graduate preferred. Associate Degree or Bachelor’s Degree preferred. Experience : Minimum of two year’s of experience in a medical front office setting with experience and knowledge of health insurance/ benefit requirements required. Two years’ experience working with medical insurance plans. Two more years’ experience working with referrals/consult processes in the ambulatory care setting. Skills : Excellent customer service skills, and comprehensive knowledge & understanding of workflow and processes in the revenue cycle environment. Excellent analytical and project management skills. Ability to work on multiple projects simultaneously and manage deadlines. Must possess good organizational skills, work independently, and prioritize multiple projects and objectives in a rapidly changing environment. Ability to communicate clearly and effectively, relate cordially with co-workers, members, providers and others. Download and save reports in Excel, and sort reports by name, date or in descending dollar order, when taking calls from patients, providers or payers, the representative needs the ability to determine the necessary action to take, such as the appropriate questions to ask, or determining the research necessary to answer questions. Knowledge of medical terminology, CPT, ICD-10-CM, and Revenue Codes, Medicare guidelines and regulations, billing and follow-up practices, billing requirements for all payer types, managed care terminology (capitation, PPO, stop loss, etc.), Cerner, Microsoft Outlook, Word, and Excel. Standards of Performance : Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality. Physical Effort : Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Minimal: Requires prolonged hours of standing and sitting and some walking. Requires extensive use of telephone and computer keyboard. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Hours of Work : Based on business need.