Patient Services Representative & Surgery Scheduler

JOB TITLE: Patient Services Representative & Surgery Scheduler

GENERAL SUMMARY OF DUTIES: 

Performs general business office functions that may include some or all of the following: charge capture; insurance verification, eligibility & pre-authorization; insurance; counseling patients on insurance and payment issues. Ensures all insurance, demographic, and eligibility information is entered into the billing system in an accurate and timely manner. Registers patients in the system. Collects co-pays, deductibles and other out of pocket amounts. Balances receipts, reconciles daily work batches and prepares audit trail. Works with physician offices to schedule surgical cases & works to maintain surgery schedule.

The Patient Services Representative performs general business office functions that may include some or all of the following: 

1. Ensure overall total customer satisfaction.
· Greet patients in a courteous and professional manner.
· Answer all incoming calls in a courteous and professional manner.
· Respond to the patients’ needs or direct them to the appropriate person for assistance.
Take detailed messages and confirm the appropriate people receive them.
· Obtain overall operational knowledge of the center in order to assist in the triage process.
· Have insurance knowledge, i.e., be aware that HMO patients need a referral for each visit
and which insurances the center accepts.

2. Ensure that patients’ needs are handled in a timely and efficient manner.
· Ensure that benefit verification and pre-certification is completed for each scheduled
case.
· Schedule patients into the billing system immediately upon receipt of the information
from the surgeon offices.
· Prepare new chart including a copy of the insurance card(s), demographic information
sheet, any referrals and obtain any signatures on center required paper work.
· Established patients – verify demographic and insurance information at each visit.
· Have knowledge of CPT-4 and ICD-9 coding, as well as the changing Medicare and
Medicaid regulations and guidelines.
· On the day of surgery, enter patient charges, payments and approved discounts into the
billing system.
· Collect unmet deductibles, coinsurance, co-payments and outstanding past due patient
balances on the day of surgery.

3. Ensure that paperwork processing is confidential, efficient and timely.

· Balance out at the end of day and perform necessary End of Day process for the center.
· Open and distribute all incoming mail and packages in accordance with policies and
procedures.
· Maintain a neat and orderly workspace and an adequate supply of charts, forms and tools
to perform the job.
· Maintain strictest confidentially of all information related to medical records,
communication between staff and the patient as well as any events surrounding the
patients’ treatment.

4. Ensure that the surgery schedule is correct & optimal

· Work closely with surgeon's offices to ensure cases are scheduled with correct procedures, times, and case order.
· Communicate with charge nurses, anesthesia, & surgical team regarding requested supplies, patient needs, etc.
· Maintain block schedules for surgeons & update as needed.

5. Perform all other duties as assigned.

REQUIREMENTS:

• High school diploma or GED required.  
• Two years minimum front office experience in a medical environment.
• Excellent communication skills, both written and verbal.
• Ability to work independently.
• Ability to understand and interpret policies and regulations.
• Must have a cell phone for system authentication & communication.
• Must adhere to facility dress code policy.