Patient Services Representative

This position is responsible for ensuring that patient collections are effectively resolved and accurately processed in a timely manner.

• Develop and maintain working knowledge of current HME products and services offered by the company and all applicable insurance guidelines respecting eligibility for coverage and reimbursement
• Demonstrated ability to identify different claim types (e.g. INN/OON claims)
• Take incoming calls from patients regarding outstanding amounts owed
• Effectively communicate with patients regarding insurance benefits and patient-pay responsibility
• Investigate any billing issues patients have whether that is insurance or self-pay related (if insurance related, pass along to the appropriate insurance collections work group)
• Maintain accurate patient charts when detailing call content and actions
• Process patient payments including payment plans and credit cards
• Effectively balance transfer paid patient amounts
• Process any related patient pay correspondence (PDPT, MPP and EOB letters)
• Coordinate any required discussion on an insurance Explanation of Benefits advice with patient and peers
• Request and coordinate missing claim information with peers
• Successfully identify collection accounts and coordinate with peers
• Assist patient on creating their online account and resetting password
• Assist patients with claim status calls to their insurance company
• Print EOB letter with patient invoices
• Provide back up to customer service when needed
• Advise supervisor of any recommended change to policy or procedure stemming from issues being presented at the patient pay level.

• Working knowledge of Microsoft Office (Mail, Word, Excel) and Internet browsing.
• Well organized, detail-oriented with excellent follow-through.
• Ability to complete tasks within a given time frame. Fosters a sense of urgency and follow through to resolve outstanding issues in a timely manner.
• Works well with others regardless of their level or background; is respectful; maintains positive relationships even under stressful or difficult circumstances; deals with different points of view or disagreements in a constructive, successful manner.
• Ability to function well while involved in multiple task assignments and in a fast-paced environment.
• Anticipates and prepares for short and long-term challenges/trends; sees how his/her work relates to others as well as the organization as a whole; understands implications of decisions; translates ideas and concepts into practical applications.
• Language: Intermediate ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence.
• Reasoning: Intermediate ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

• College graduate or equivalent, preferably RN but not required
• Medical terminology and medical insurance industry experience preferred
• Experience with Brightree software preferred
• Familiarity with home medical equipment and related supplies preferred
• Knowledge of major insurance carrier reimbursement guidelines and coverage (preferred)

While performing the duties of this job, the employee is occasionally exposed to the following conditions: work near moving mechanical parts. The noise level in the work environment is usually moderate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is regularly required to sit, talk, hear and use hands. The employee is occasionally required to stand, walk, reach with hands and arms, stoop, kneel, crouch, crawl, taste/ smell, and lift/move (up to 25 lbs). Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Comprehensive healthcare benefits package.
• Professional development opportunities.
• Holiday & Overtime Pay